Iowa Trailblazes with Initiative To Reduce Unintended Pregnancy

Lawrence B. Finer

Anti-choice forces have recently launched a new offensive - on birth control. But in Iowa, common sense prevails in a new initiative to reduce unintended pregnancies using contraception and family planning services.

Many Americans may be unaware
that right-wing activists have launched a new offensive in the culture
wars, targeting large numbers of people not accustomed to finding themselves
in the crosshairs of such attacks – the millions of American couples,
including married ones, who use birth control.

National and regional anti-contraception
activists declared June 7 "Protest the Pill Day." This date is highly
symbolic. It was on June 7, 1965, that the U.S. Supreme Court first
recognized the right of married people to use birth control, a right
it extended a few years later to unmarried people as well. And it is
this basic right, which virtually all Americans today take for granted,
that anti-contraception activists find objectionable. They have
designed an entire campaign to promote their opposition to modern birth
control methods, including a web site full of misleading and outright
false information denigrating the safety and effectiveness of the pill.

Back in the real world, however,
Americans understand the value and benefits of birth control and overwhelmingly
support and use it: Ninety-eight percent
of sexually active Americans have used contraception
at some point in their lives, and
89% of American women at risk of unintended pregnancy are currently
using birth control.

Individuals are, of course,
free to renounce contraception as part of their personal belief system.
But imposing this ideology on others makes for terrible public health
policy. Using any form of birth control dramatically reduces the chance
of having an unintended pregnancy. That’s why birth control
users have disproportionately few unintended pregnancies – and, by extension,
abortions. Of almost 43 million U.S. women at risk of unintended pregnancy,
the 11% not using contraceptives account for almost half of all abortions.
Less use of contraceptives, as the anti-birth control extremists advocate,
would lead to dramatic increases in unintended pregnancies, and many
more abortions.

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Rather than criticizing birth
control, we should instead focus on doing more to help women and their
partners prevent unintended pregnancy. And that’s where Iowa has been
a trailblazer of late. In January of this year, the Iowa Initiative
to Reduce Unintended Pregnancies

was launched to educate young women and men about contraception and
make it easier for them to obtain family planning counseling and services.

Iowa is a good place to start
such an initiative. A 2006 Guttmacher
Institute analysis

ranked the Hawkeye State 48th among the 50 states and the District of
Columbia in how well it met the existing need for subsidized contraceptive
services and supplies. (Iowa ranked 36th overall when other factors,
such as laws and policies, were taken into account.) There’s clearly
room for improvement, and the Iowa Initiative demonstrates a strong
commitment to doing better. Iowa already took an important step in 2006
(after we had completed our report) when it raised the income level
at which clients are eligible to receive subsidized contraceptive
services and counseling through Medicaid
Iowa has also substantially increased the amount of state-controlled
funding allocated to family planning.

Reducing Iowa’s rate of unintended
pregnancy is not only a worthy goal in and of itself, it would also
help reduce the number of abortions in the state. Iowa’s abortion
rate increased 8% between 2000 and 2005
while the national rate fell 9%. That made Iowa one of only a dozen
states that saw an increase in the number of abortions (although it
should be noted that Iowa’s abortion rate continues to be well below
the national average).

The Iowa Initiative embodies
the type of smart, evidence-based approach that we should be promoting
nationwide, given the still-high rates of unintended pregnancy and abortion
in the United States. Providing information on the full range of birth
control options, making methods easily available to women and couples,
and subsidizing them for those with low incomes through Medicaid and
the federal Title X family planning program, are some of the most obvious,
effective and compassionate public health policies available to us today

So enough with the retrogressive
idea of a contraception-free society. We have an obligation to
give all women and men the know-how and means to avoid pregnancies they
themselves do not want. And no matter where one stands on the
abortion issue, it’s clear that the commonsense approach of improving
contraceptive services and counseling can help us achieve this goal.
Providing access to birth control allows Americans to make responsible
decisions about when to become parents, a much better approach than
allowing anti-contraception zealots to make the decision for them.

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