Consider the Source

As we continue the skirmish known variously as The Battle for Religious Freedom and The War on Women, I continue to be fascinated by the underlying assumptions and agendas behind the contested portion of the HHS mandate. To repeat what often gets lost, Catholic leaders are not taking issue with the President’s health care plan–indeed, Catholics were strongly in favor of broadening access to healthcare–or even with many of the other women’s health initiatives among which the disputed regulation is included. We’re all for equalizing access to screening for diabetes and heart disease, among a number of other areas in which coverage for women’s health care lagged behind that for men. The piece that we object to, on grounds that have been well spelled out in recent lawsuits, is the mandate that requires employers to provide a full range of contraceptive services (including those the Church, which teaches that life begins at conception and not at implantation, defines as abortifacients) and sterilization at no cost to their female employees as part of covered preventive care.

The administration believes it has made a compelling case for overriding conscience concerns. This case draws on recommendations made by the National Institute of Medicine in a July 2011 white paper. This outlines in detail the “public health emergency” upon which the case for the mandate has been made, but here is a quick summary, as objectively worded as I can manage:

  • US women are at risk of unintended pregnancy. This risk is heightened among young, poor, uneducated, nonwhite women.
  • Unintended pregnancy is a health risk to both women and their children because unwanted pregnancies lead directly to higher rates of depression, drug abuse, child abuse, and stress. All unintended pregnancies are unwanted pregnancies. These risks are in addition to the risks that come from pregnancy; women who are not pregnant are healthier than women who are.
  • Unintended pregnancies have economic consequences for society. Pregnancies cost society more than population control.
  • The chief contributing factor for the public health emergency of unintended pregnancy is lack of access to reliable forms of contraception. This lack of access is chiefly economic.
  • The types of contraception most effective against unintended pregnancy are those that remove the need for user compliance (sterilization, IUDs, and implants); this is particularly true among young, poor, and uneducated women who are not reliable when having to use methods that make them have to make a decision at the time of intercourse. The most effective methods, however, are the most expensive.
  • Women would choose these more effective methods in much higher numbers than they do now if cost were not an object.

My mother always used to tell me to “consider the source,” so I read the NIM study and checked the research on which it (and the subsequent HHS mandate) was based. It was not surprising that every single premise drew on research from the Guttmacher Institute of Planned Parenthood. Nor was it surprising that President Obama, to whom Planned Parenthood is a key donor, would be adamant about enforcing directives based on its agenda.

When this first emerged, I began tracking what I knew would follow: a flurry of MSM op-ed pieces, health blogs, and new studies reinforcing the notion that longterm, compliance-light methods of contraception are the solution to women’s health and the country’s progress. Another one hit today, in the New England Journal of Medicine. Based on studies conducted in St Louis, it repeats the claim that IUDs and implants are highly effective in preventing the “disease” of pregnancy, and glosses over the very real health risks associated with these methods. The study was funded by the Susan Thompson Buffett Foundation (started by Warren Buffett and named for his wife), a major funder of and recipient of donations from–surprise! surprise!–Planned Parenthood. Two of the study’s authors are quite forthcoming about being in the pay of the companies that manufacture IUDs and implantables. Ho hum.

But another study is also making news today–one I only learned about from attempts to refute it because it turns the party line on its head. In the Journal of Economic Perspectives, Melissa S. Kearney and Phillip B. Levine ask “Why is the teen birthrate in the United States so high and why does it matter?” In their extensive review of studies (which include, but are not limited to, some conducted by Guttmacher Institute researchers) Kearney and Levine refute nearly every premise behind the HHS mandate. They present a persuasive case for looking at teen and young adult pregnancy not as a disease, but as a symptom of poverty and lack of alternatives. Among their findings:

  • Unintended pregnancy rarely correlates with unwanted pregnancy or unhappiness, even when women note that their pregnancies resulted from contraceptive failure.
  • Only 2% of young sexually active poor women who were not using contraception cited the cost of contraception as prohibitive. 
  • Women in the NIM’s “high risk” category become pregnant and remain pregnant by choice in much higher numbers than Planned Parenthood’s studies reflect.
  • Pregnancy is not a statistical factor in women’s ability to escape poverty. There is no economic difference between poor women who have had children as teenagers or young adults and poor women who have not.
  • Factors that do make a difference include access to education, employment, reliable child care–and marriage.

These unpopular premises have little to do with preventive health care and women’s rights, and more to do with making our society one more supportive of families at all economic levels. (In other words, it’s the economy, stupid.) They counteract the Prevailing Myth, so it’s no wonder there’s a rush to refute them. No one’s yet accused Kearney and Levine of being sock puppets for Cardinal Dolan (though there’s much in their study that the Church has been saying all along), though I’m sure that shoe will drop soon.

Meanwhile, check all this out for yourself. Think. And consider the source.

  • Athanasius contra mundum

    "Unintended pregnancies have economic consequences for society. Pregnancies cost society more than population control."I guess they don't think long term. If the population is aged and reduced because of population control then who is going to be there to take of that aging population as their medical needs skyrocket and their economic contributions plummet due to their old age and infirmity.For an example, the Russian government is desperately trying to increase the birthrate to avoid just such a demographic catastrophe.

  • Michael

    Please find a good economist who can provide simple number:If the HHS Mandate stands, how many millions (billions?) of federal dollars will go to Planned Parenthood each year?Isn't the mandate a political endrun around all the state and federal legislatures de-funding PP? We are turning off spigots and they just cranked open a fire hydrant. The mandate seems poised to make Planned Parenthood the largest single supplier of "healthcare" in the nation.We're so focused on the tree of 'conscience protection' that we're missing the much, MUCH larger forest.

  • ElizabethK

    Joanne, this is an amazing post–thank you. It's been hard for me to take seriously the idea that people really think there's a War on Women here, and that this is anything other than a cynical political ploy. I think we (I) need to get past that, though, and really start to dig into the underlying premises of those who are so vehement that this mandate is necessary. I'm fascinated both by the white paper–which helps me to parse some conversations I've had recently– and by this new study (which makes much more sense to me, just based on what I know of the world we live in!)

  • Philip Frederick

    THANK YOU! It is so fantastic to see someone out there who gets it. This attempted healthcare solution by our government hearkens back to the 20th century efforts to reduce poverty through methods of sterilization. Their is a desire to find a magic bullet, but it is not there. It IS the economy.

  • Elizabeth Gabhart

    The author makes some good points that data can be interpreted in a variety of ways. I, too, have seen some of the research she cites at the end. However, the data cited at the end is misleading.Poor teens do choose pregnancy in higher numbers than middle-class or richer teens, but that's because they already feel their life chances are so limited, what further harm could possibly be done by being pregnant? It's not that becoming a mom bears no penalties for women; it does, and that's empirically verified. It's disingenuous and misguided to cite the fact that poor women "choose" pregnancy when these women are simply choosing between many bad choices, when nobody (including these women) thinks these choices are fair or good. Yes, pregnancy doesn't make a statistical difference in whether or not women escape poverty, but it doesn't help. Few things allow poor women to escape poverty, and those few things are generally difficult for poor women to obtain. In my business, it's called "social reproduction" — poor women have poor babies who generally continue to be poor. The US has a terrible record on upward mobility and yes, it is true that pregnancy doesn't seem to matter much. This doesn't mean that the pregnancy of poor women is a good thing. Also, if you care about the factors cited as making a difference for poor women — education, employment, child care, and marriage — vote Democrat, not Republican. Don't win the battle over contraceptives and then lose the war on poverty.She cites the fact that most poor pregnant women say the cost of contraception is not prohibitive for them. My head exploded when she read that. Planned Parenthood is the number one provider of contraception for poor women! You can't write an article attacking Planned Parenthood, and in the article say, "Besides, most poor women get cheap contraception anyway," as though PP isn't the one doing it! Where does she think it's going to come from if not PP? Last, there is a "motherhood penalty" economically. It's well-established, well-verified. If you take mothers out of the economic comparisons, women actually earn somewhere close to men. With mothers included, women only earn 77% of so of what men earn. The motherhood penalty in earnings is steep. The earlier in a women's life she has kids, the poorer she is likely to remain because the less money she will make every year and over a lifetime. This author is taking a situation where there is virtually no upward mobility and then saying, "Look, pregnancy doesn't decrease chances that a woman will leave poverty," when in reality very few people leave poverty under any circumstances — male, female, white, Black, Hispanic, etc. Then she ignores or dismisses the fact that mothers WILL get paid significantly less over a lifetime and pretends that pregnancy makes no difference for poor women. Okay, so most women with kids never leave poverty, but neither do most people who are poor, and the women with kids ARE poorer than the other poor people in her category. The author is dead wrong. This is not a liberal bias; it's reality. Even common sense (without including science) can tell you that poor women with kids will have harder lives than poor women without kids. Kids haven't consistently increased a family's income and ability to live comfortably since the Industrial Revolution.

  • Joanne K. McPortland

    I don't disagree with some of your points, and I would hope that all readers would resist the temptation to make this about politics. I am a Democrat, but I'm also a Catholic (believe me, both sides think that's an impossibility), and I do believe that women will not emerge from poverty until the social situation is improved for families. My point is not that women who don't get pregnant aren't better off economically; it's that there are MANY reasons young women aren't using contraception, and availability and cost are not, as the NIM guidelines and HHS mandate declare, the sole determining factors. I am happy to have PP provide contraceptives through government funding and/or donations for women who choose to use them; what I don't think is warranted is requiring that contraceptive services be covered free of charge as preventive medicine by all employers to all women, especially when that requirement presents a clear conflict to the free exercise of religion.The real pro-choice position here is to allow women–no matter how young, poor, or uneducated–the ability to make their own choices, instead of running a government campaign to convince them that their only chance to get out of poverty is sterilization or long-term forms of contraception that are associated with significant levels of risk, no matter what doctors paid by pharma want us to believe. And I am hard put to understand how it's liberal to promote the notion that only well-off, college-educated white women should have children.People will disagree, both with the accuracy of my summaries and the points I'm making, which is why I provide links to the full studies in all sides.

  • Anonymous

    When you say "they already feel their life chances are so limited, what further harm could possibly be done by being pregnant?" I don't disagree that that's what it could look like from the outside… but as someone who has had close relationships with many girls who make that choice, my expirience tells me the internal monolouges go a little differently. Everone knows pregnancy and motherhood are tough. Poor girls are more likely to have an early recognition of the reality that life is tough in lots of ways, and see this as their cross to bear. Middle and upper class girls are more likely to remain in a stage of immature selfishness (a natural state that all children go through… but some take longer than others to grow out of). Because they are more sheltered from real hardships that exist in the world, they are more likely to believe in the myth of an easy care free existance and think themselves entitled to it.

  • Elizabeth Gabhart

    Joanne, I appreciate your thoughtful reply, and I hope that I can disagree respectfully. Here's one of the articles from my discipline which show that, in fact, women who don't get pregnant ARE better off economically: know you wrote that you agree with this research in some way, but I think it might be helpful to go ahead and link it.You're right of course that availability and cost are not the only reasons for lack of contraception use. There's almost nothing in human behavior that can be chalked up to only one cause. However, it is a cause, and it's a cause that is probably easier to tackle than, "I want to get pregnant so my boyfriend and I can be together forever" or some other nonsense. We can't tackle all causes of teen and/or unwanted pregnancy, but we can tackle this one. Why not try?I understand the argument that employers who believe contraceptives are immoral might be uncomfortable providing them for women, but that's part of the social contract of living in a democracy. I'm uncomfortable for my tax dollars to go to fund wars, the CIA, or the FBI, but I pay for them anyway. As a person who believes that zero or negative population growth are admirable goals, I don't like supporting fertility treatments, but in the past I helped a friend get fertility treatments. (She still has no idea I'm against population growth.) Part of living with others as well as creating a social contract is allowing them (and sometimes even supporting them) in choices that we disagree with.Further, this objection hurts lots of women like me who use birth control for medical reasons. My ex-husband had a vasectomy, and I still used birth control because it helped keep my migraines manageable. I am incapable of functioning without it. Your religious "right" runs squarely against my medical "right", which ends up putting us in a debate that echoes the conundrums caused by people who believe blood transfusions are against God's will. How do you believe that should be handled? Should your employer who is a Jehovah's Witness deny coverage of your blood transfusion? Heck, I know Wiccans who believe that antibiotics are wrong because their commitment to ahisma means they don't even want to kill bacteria. Should your Wiccan employer have the right to deny you antibiotics? As a person who believes in negative population growth, if I were your employer, should I have the right to deny coverage of any of your fertility treatments? Please note that I'm not making a slippery slope argument. I'm not saying that in 20 or 30 years, eventually this legislation might lead to something bad; I'm saying it's already leading to the bad things I'm citing. The legislation now, today, leaves room for employers who don't want to provide coverage to just not provide coverage.

  • Elizabeth Gabhart

    More of my response here…You make an excellent point that some liberals seem to believe that only well-educated, white women should have children. I hope that I don't say anything to align myself with that crowd, and if I do, please point it out and I will apologize. However, as I understand it, that's not what we're talking about. We're talking about women having the choice of children or not, and these policies will leave it so that few women outside of well-off, educated white women will have a choice. To my knowledge, no one is forcing racial minority women to be sterile or to take birth control against their will. In fact, denying major chunks of the population access to birth control due to financial pressure will keep those chunks of the population from being able to make choices they might otherwise make. I fail to see how making poor women pay out of pocket for "options" they cannot realistically afford is, as you call it, the "real pro-choice position". Your position allows choice for the employers, only in what they will and will not cover, but my position allows choice for the employees in what they do with their bodies (what pills they take or do not take, etc.). I guess in the sense that you're pro-employer-choice, you can call yourself pro-choice, but please don't think for a minute that denying women the necessary financial coverage of medication means that you're somehow giving those women the "choice" to take the medication or not. If you applied your statement to any other medication which is usually insured (like insulin or antibiotics) I think you'd see how ludicrous it is to insist that lack of medical coverage means more choices of medicine.You wrote that poor women should not be exposed to a "government campaign" to convince them that not having kids will help them get out of poverty. Perhaps you didn't mean it this way, but I imagine that you view this as almost conspiratorial. However, facts are facts, and there IS a well-established motherhood penalty. If our government told women that they can be just as well-off financially if they have babies or not, our government would be at best guilty of refusing to fact-check, and at worst lying. Although you disagree with the outcomes of our government telling the truth, I would prefer that you at least acknowledge that this "campaign" isn't an evil conspiracy, but a well-meaning attempt to curb poverty. Hopefully you didn't mean it that way.As for the risks associated with contraception, I haven't yet seen credible evidence of that, but I admit that I'm a Sociologist and not in medicine. However, I do know that poverty reduces the average person's lifespan in the United States by 6.5 years, and reduces quality of life dramatically. I would like to see data on how many years contraceptives, which you say are unhealthy and risky, decrease lifespan. It would be wonderful if that data included information about quality of life of women who take contraceptives. I realize this is a tall order, since contraceptive use has high concurrence with other life factors which may also increase or decrease life span, but if you have access to such data, I'd love to see it. You may be right that the risks of contraceptives outweigh the risks of the motherhood penalty. Show me, please.

  • Holly Murphy

    A girl who gets pregnant has a better opportunity to get out of her situation. Because she can get education help, she can offer the baby up for adoption and not contribute to the declining population, or she can choose to sink into her poverty and despair and raise children who will live like she, and possibly their grandmother did. I see in my children's family and in my prior employment in social work systemic poverty that consequently lasts for generations. Some of my children were taken out of that and still seem bent on going back to it. I would guess that a girls chances of coming out of poverty in this situation have much more to do with her ability to make plans and good choices.excellent article!Holly

  • Julie D.

    Joanne, brilliantly done and a good reminder to me to read and think for myself. :-)

  • Anonymous

    If we are not supposed to make this about politics–then why has the Democratic Party with (Obama at the top) done everything in their power to promote the Planned Parenthood agenda? It would seem that they are in PP's pocket and my– how the D. Party support, promote and tries to enforce the abortion agenda– so how can we NOT bring politics into it?? They have.

  • Joanne K. McPortland

    Elizabeth, thank you for sticking with me and clarifying the places where we have agreement. A couple more: It is obvious that over a lifetime, having a child is more expensive than not having a child. I will even grant that poor women with children might have a harder time getting out of poverty than poor women without children, all other factors being equal. And I would never claim that the health risks of contraception outweigh those of pregnancy. What I am saying, and what is being left out of the discussion (if I can use such a polite word :) ) on the HHS mandate, is that being pregnant does not cause poverty. It does not immediately result in the horrific personal health risks and high social costs that the NIM guidelines use to justify making free contraceptive services a critically needed piece of preventive health care. I am saying that when the research goes beyond studies funded solely by PP and pharma, the premises do not hold up. Poor women are NOT without access to affordable contraception or sex education, and teen pregnancy is not solely a result of this lack of access. Pregnancies described as unintended are not always unwanted. There are many, many ways in which quality reproductive health care is now being provided to women of all socioeconomic strata, and there are many, many ways in which this access could be widened without including it as a no-copay covered expense and triggering the conscience objections. What there can't be–and here's the important part–is free or low-cost access to the highest-cost options, which pharma and PP have been pushing for decades despite huge resistance, the first for profit reasons, the second for a social agenda that has been racist and eugenic from its beginnings. I do not understand how a mixed-race president who is the child of a poor single mother–all of which factors make his birth "unwanted" according to the NIM–can be such a strong champion of this agenda. (I voted for President Obama, btw, and this is not the only arena in which I am deeply disappointed with him. I am not a Mitt fan, either. So this isn't politics for me. It's real questioning.) And in the end, the HHS mandate isn't about poor teens at all–it's about supplying high-cost drugs and services to women with jobs that include health-care coverage. If we are going to supply free preventive substances, there's a much better case for requiring employers to pour their employees a free glass of red wine every day. (You'd get no argument from the Catholics on that, though the Mormons and Baptists might bring their own lawuits.)

  • Elizabeth Gabhart

    Joanne, thanks for an honest, frank, but polite discussion. I love discussions like these!Perhaps pregnancy does not "cause poverty", but the research I linked showed that being a mother does, in fact, seriously decrease a woman's earning power. There is an economic motherhood penalty. Whether this pushes a mother over into outright poverty probably depends on her economic condition before the pregnancy and the definition of poverty. Either way, your issue here must be mostly semantic. Mothers get paid far less over a lifetime than non-mothers. If you take umbrage with the words "motherhood causes poverty" I think you're disliking the words, not the facts the words are pointing toward. And, by the way, I'm not arguing that this fact is fair. It's far from fair. But it is a fact that being a mother bears an economic penalty, and people who try to eradicate poverty should be able to point this out without being accused of being anti-mother.Perhaps the NIM guidelines point to some sort of "horrific personal health risks" of pregnancy that I'm not familiar with. However, I can tell you that on my liberal side of the debate, I haven't heard any talk of women being subjected to the personal health risks of pregnancy. Instead, liberals I'm familiar with simply want all women, poor and rich, to have choices.Again, you say that poor women have access to affordable contraception, and again, I challenge you to find anyone who provides that as consistently as Planned Parenthood. I know, I've tried. I'm a woman living FAR below the poverty line and a single mom, and I've tapped out every available option for the birth control pills that curb my migraines besides Planned Parenthood. Give me reasonable access to another option, and I'd be happy to go there. In the meantime, please stop attacking Planned Parenthood in the same breath as saying, "Poor women can find contraception if they want to." Walk-in clinics will not give out pills, nor will my university clinic which I can access for free. Both of those will prescribe me anything BUT birth control pills. Every resource I've called recommends only Planned Parenthood. You say, "Poor women are NOT without access to affordable contraception…" Show me, because I would be grateful for life.What evidence do you have that Planned Parenthood is trying to commit eugenics against minority women? Even if you somehow find solid evidence that it started that way, what evidence do you have that it's working? Racial minority, poor, and uneducated women generally have higher birth rates than white, richer, and educated women. If Planned Parenthood has a secret eugenics policy, it's failing miserably. This is an outrageous claim, and it demands an outrageous amount of evidence. If this claim is true, you also need to provide evidence that Obama knows about it, and that he believes the eugenics conspiracy is working and doesn't care before you cast aspersions on him. I do know that Obama publicly claims to care about poverty, and that most liberals see a fight against poverty (not eugenics) in Planned Parenthood. Even if you leave this discussion believing Obama is misguided, please rethink your position that he is akin to Hitler. I also voted for him, and I am also deeply disappointed in him, but not because I believe he is part of a eugenics conspiracy.You're right that Mormons and Baptists would disagree with a mandate requiring them to feed their employees red wine every day. I wish this train would lead you to address my earlier questions about Jehovah's Witnesses, some Wiccans, and my negative population growth beliefs.

  • Elizabeth Gabhart

    To Anonymous: You asked (in a very nice way) about why I presumed to know what poor moms think. The information I have is from 162 interviews of single moms as outlined in the book, "Promises I can Keep: Why Poor Women Put Motherhood Before Marriage", by Edin and Kefalas. You're right, of course, that women are independent agents who have individually different and probably also internally conflicting reasons for becoming pregnant. I don't want to discredit your knowledge of that group of women. However, Edin and Kefalas found that what I described was one of the dominant reasons why poor women became pregnant. Motherhood has high status in poorer communities, and if women have few paths to status through education and career, many choose to gain status through motherhood. Given a real choice instead of many slammed doors, most women would apparently choose to feel their lives are valuable through other means than teen pregnancy.Edin and Kefalas talked about exactly what you describe, how poor teens seemed to embrace maturity and motherhood sooner than they expected! You might really enjoy that book. :)

  • Anonymous

    I'm seeing a lot of good points on both sides…But the biggest issue for me is this: No one has the "right" to make a decision and then be free from the consequences. Don't want to get pregnant? There's a great way to make sure you don't. It's called, "Don't Have Sex," or if you do have sex, do it during your infertile time of the month (yes, that time exists, and no, the rhythm method isn't the only way to figure out when it is). The reason that pill was created wasn't pregnancy prevention. There was already a great way to do that! The pill was created to enable a lifestyle and a certain type of behavior. (As a side note, no one has ever died from not having sex). With every right comes a corresponding responsibility. ALL of the rights we enjoy as citizens go hand-in-hand with duties and obligations as citizens. I'm sorry that many women are frustrated by their biology, by the fact that they're unable to have baby-free sex without taking a pill, but they're going to have to take that one up with God. Sure, it's not fair, but it isn't the government's job to make everything fair. And it's certainly not our job to pay for the lifestyle choices other people make. -MM

  • Julie

    While I see where you are going in this piece, I have to point out that it is not The Church that defines an abortifacient as an abortifacient, it is science and reason that do.

  • WalkingShark

    So this is all a Machiavellian scheme to funnel money to Planned Parenthood so they can provide cheap health care to poor women?If this is what passes for an evil plan these days, they're doing it wrong.

  • Alan R.

    To Elizabeth G. and Joanne,I wanted to thank you for the way you have both expressed yourself in the comments. I don't often come across a civil discussion on this topic.To Elizabeth, I'm pretty sure that P.P. does have it's beginning in Eugenics. I searched "is planned parenthood eugenics?" If P.P. has failed in their eugenics purpose set at it founding, it's not for lack of trying. Also, the president may not be aware of the relationship between P.P. and eugenics but he should be. It would be one thing to be uninformed if supporing P.P. was his personal action but the HHS mandate is to be law. As a law, it will force those that can not morally use or support the use of contraception to do that or pay a fine. You said "I'm uncomfortable for my tax dollars to go to fund wars, the CIA, or the FBI, but I pay for them anyway." On the issue of contracption, It's not that I'm uncomfortable with it being availabe, it's that I can not support it. And when I mean I can not, I don't mean I don't like to, I mean I can't. From reading your comments about the relationship of poverty and motherhood, I would like to state that poverty is a social construct, privation is not. I believe that trying to eliminate poverty causes misguided public policy even if the intention is good.My intention in commenting to you was not to put you on the defensive. I believe that your intentions are good even though I do not agree with you on the best way to help those in need. Thank you,Alan R.

  • ken_h

    (my comments have to be posted in two parts. Here is the first part.)I'm sure that you'll shoot this comment full of holes, but it seems to me that we have a system in this country that is based on a constant stream of earning from the private sector (since the government does not produce anything of worth in and of itself – note that I did not say anything of value, but it does rely on income from other sources other than itself, at least if we are to have a healthy economic and social system.) This earning can only come from having a "supply" of human capital (just to refer to it in some way) to fuel that system through their labors. It also needs a strong system of private enterprise to provide jobs and an income to those humans, so that they can in turn pay taxes and fund the operations of the government so that it can fill the necessary role that it provides. These people can only come from one place – they must be born.As I was reading this, the "motherhood penalty" that you cited must be real, I have no doubt. Or at least something that looks like a penalty, because the short-term outlook is "reduced earnings." But I think that it is probably only showing up that way because the payback time for having a child, raising it to be a productive member of society, and in the long run contributing to the support of the society that will eventually help to support the mother (and father) in their old age is fairly long. I would propose that this system needs a mother and father to be together to support one another in the raising of their children, with the father (or mother) being able to earn a living wage, support the mother (or father) and children through that wage, as well as them doing their part to contribute to society (as well as pay taxes to fund necessary government operations.) And raise the children that will sustain the system in the longer term. The work of raising the children and having that future support is really the "earnings" that are apparently sacrificed in the short term for this long term "payback."I would say that this system, then, needs to have strong families who are committed to (a) getting married. (b)staying together, and (c) raising their children as best they can. The model of an unmarried or single mother does not really fit this system. It should be discouraged, or more appropriately, the "married family" model should be presented as a preferred option. It might be a "status" raiser for mothers in poorer communities to have children. And that would most likely preclude some other opportunities for those women, no doubt. I am not advocating the "barefoot and pregnant" model. Education for all is good. Women as well as men should be able to work. And an educated "mom" (or "dad") is certainly more likely to be better equipped to raise the children of the family in those years when they are dependent on the nurturing of a family to grow and develop. The thing that seems to be missing these days is the strong family (man and woman being married, working together) and the jobs that go along with that.I see a better "system" as one that supports strong families raising their children, supports a robust private enterprise system to provide jobs and capital. It seems that the so-called "abstinence" programs that would teach the values that would support this system would be a good place to invest. And anything that could strengthen the institution of marriage as a place for rearing of children should be a goal. I think that government and society is just investing in the wrong places to have a healthy society.(second part follows)

  • ken_h

    (This is the second part, but I forgot where I clipped my comment. I might have some overlap.)I would say that this system, then, needs to have strong families who are committed to (a) getting married. (b)staying together, and (c) raising their children as best they can. The model of an unmarried or single mother does not really fit this system. It should be discouraged, or more appropriately, the "married family" model should be presented as a preferred option. It might be a "status" raiser for mothers in poorer communities to have children. And that would most likely preclude some other opportunities for those women, no doubt. I am not advocating the "barefoot and pregnant" model. Education for all is good. Women as well as men should be able to work. And an educated "mom" (or "dad") is certainly more likely to be better equipped to raise the children of the family in those years when they are dependent on the nurturing of a family to grow and develop. The thing that seems to be missing these days is the strong family (man and woman being married, working together) and the jobs that go along with that.I see a better "system" as one that supports strong families raising their children, supports a robust private enterprise system to provide jobs and capital. It seems that the so-called "abstinence" programs that would teach the values that would support this system would be a good place to invest. And anything that could strengthen the institution of marriage as a place for rearing of children should be a goal. I think that government and society is just investing in the wrong places to have a healthy society.I was just scanning back over the previous comments, and this might sound glib, but abstinence is an affordable way to prevent pregnancy.Another point – you mentioned the religious practice that would prevent you from being able to use birth control for medical purposes. The Catholic Church (for example) does not forbid using medications that also have abortifacient side-effects when there are other "non-birth-control" needs that can only be treated with these medications. Your migraines might be such a situation.Those were just some thoughts that might not fit in with these studies and the "prevailing wisdom" of society and the governmental agendas (if I may use that term.)Interesting reading this discussion and all of the points that have been brought up. I should take the time to go and look at all of these other studies, because these issues are definitely in areas that are well outside my expertise (although not outside my experience.)Thanks for reading through this, I was not trying to be insulting or hurtful in any way, I hope that nothing came across as such.

  • Anonymous

    Side factor: One reason for the doomsayers on the Social Security financing problem (which was last settled on an agreement between President Reagan and Speaker Tip O'Neil in the 1980s) is that the Baby Boom generation has, in aggregate, given birth to TOO FEW children to support the Boomers when the Boomers become mostly over age 65 – before 2030 A.D.The papers developed by the Guttmacher people fail to consider the consequences for the USA's old age pension schemes of the declining birth rates. Current trends if not altered lead to a future where most old age pensioners are European ancestored, and most workers are Hispanic immigrants. This future has seeds of instability within it, as the workers begin to resent higher and higher Social Security taxes to support the aged, most of whom are of another ethnic group.This is off the main train of this column, but perhaps s/b considered.TeaPot562

  • Don

    Elizabeth, The Catholic Church accepts and allows "the Pill" for medical reasons not related to birth control, such as what you describe for migraine management. (Although, as a "retired" Physician's Assistant, there are probably other and better? medications that would do the trick as well.)Stopping pregnancy by "medical" means is not something that the Catholic Church supports though. It is not a disease or illness. It is a result of an act taken by two people. If children are not desired, don't have sex! A person does not need to take a pill at that point.MANY medical studies have shown that most of the contraceptive options, if not all, aside from not having sex, cause other medical problems that are more permanent than having children (health wise).Yes, there can be economic back fall from having an "unwanted child", which may keep a person in the poverty level, but economic studies have shown even those people can pull themselves up if they work at it.Friar Don, OBR

  • Elizabeth Gabhart

    Ken, I so appreciate you reading my comments, responding thoughtfully, and being kind. As soon as debates turn into ugly name-calling, I just leave them, so I always appreciate a debate that continues to be two friendly people sharing ideas. Thank you so much for this! Likewise, if I come across as insulting, please call me on it and I will apologize.I definitely see what you're saying, that society needs more children to be born to support government, to support their parents in old age, and the other reasons you mentioned. However, I ask you, do you really think contraception as it is currently used is creating a world in which humans are dwindling as a species? There are 7 billion of us on the planet, so even if so many people used contraception that our numbers were reduced to 10% of what they are now, we'd still be in absolutely no danger of extinction. Compare our numbers to another mammal like deer, which are far less numerous, but are still hunted to try to control populations. I'm not suggesting an immoral behavior such as hunting humans, but I am drawing a comparison to bring home the point that we are far, far from extinction and far from having any sort of emergency that requires boosting populations. Although I may be confused about your point (and if I am, please clarify), it seems that you are advocating a blend between a traditional family model and a modern family. You seem to be in favor of one man and one woman bearing children, but you also seem to be in favor of both being educated and having the choice to work. Wouldn't this mean you're in favor of contraception? I'm really not sure if you wrote this in support of contraception or not, as your ideas lend themselves naturally to support for contraception, but you end by saying you hope you're not insulting. I think I'm confused. I think it seems as though you must support contraception because realistically after women get pregnant and raise children, their options for work and education start dwindling immediately.You wrote about abstinence. Of course, that's the ideal. No one, even most political and religious liberals, think it's a good idea for teens to experiment with sex that can lead to pregnancy, STD's, and physically dangerous situations like rape and kidnapping. I'm sure some liberal talking heads on TV might advocate teen sex, but they don't speak for most liberals any more than the conservative talking heads speak for most conservatives. However, in my opinion, liberals like me consider ourselves realists. There's never, in the history of the world, been a society in which widespread teen abstinence has been documented. Heck, even among the mammals formerly considered "monogamous", DNA testing shows that very few mammals actually mate monogamously for life. In my opinion, while abstinence is obviously a favorite ideal for teens, it's wildly unrealistic, and the consequences for wide-eyed, bushy-tailed, optimistic hope that teens will be abstinent is that teens have high rates of pregnancy, STD's, and dangerous behavior. In my opinion, conservatives continue to push this ideal in the fact of the evidence that very few teens are living up to it, while liberals admit the ideal exist and then try to make life better in the real world. I've been told several times that the Catholic church would not disapprove of my use of birth control, since it's clearly medical. However, 1 – this isn't just about me; it's about the rights of women everywhere to choose for themselves to consult doctors and do what they need to do. 2 – I shouldn't have to "defend" my right to use birth control by explaining why I use it before I get access to it, as though I am a child, which some of this legislation attempted to force me to do. 3 – The Catholic church believes that contraception is murder, but it's okay to murder as long as I'm preventing headaches? Are you sure you actually believe it's murder?

  • ElizabethK

    Just a small point to add to this, but the fact is that only 36% of abortions in this country are done on white women, so abortions are disproportionately being given to minority women. Eg., African-Americans account for about 12% of the population, but 30% of overall abortions. (From Guttmacher, PP's research arm: "Non-Hispanic white women account for 36% of abortions, non-Hispanic black women for 30%, Hispanic women for 25% and women of other races for 9%." Given PP's role as the largest abortion provider, it stands to reason that they perform a great number of those abortions. Is this intentional eugenics? I don't know–but Margaret Sanger was a eugenicist, and a proud one, and one of the main purposes of PP in its infancy was to reduce the number of minorities in the world. The statistics are certainly very troubling.

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