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.