News Abortion

Women’s Lives Are Worth More Than “But, Hey….”

Robin Marty

A Mississippi legislator doesn't worry about dangerous abortions, because at least they've stood up for "moral values."

Without court intervention, the state of Mississippi will lose access to safe, legal abortion as of July 1st. And to Mississippi Representative Bubba Carpenter, that’s just fine. Speaking to a group of local Republicans, Rep. Carpenter explains how the legislature knew when they passed the bill that the doctors would be unlikely to get admitting privileges and the clinic would be forced to close. Even if it drove women to dangerous lengths to have an abortion it would be worth it, for “moral values.”

Via Rachel Maddow:

“It’s going to be challenged, of course, in the Supreme Court and all — but literally, we stopped abortion in the state of Mississippi, legally, without having to–  Roe vs. Wade. So we’ve done that. I was proud of it. The governor signed it into law. And of course, there you have the other side. They’re like, ‘Well, the poor pitiful women that can’t afford to go out of state are just going to start doing them at home with a coat hanger. That’s what we’ve learned over and over and over.’

“But hey, you have to have moral values.”

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

His definition of “moral values” appears to be somewhat different than mine. 

Commentary Sexual Health

IUDs Might Be Exciting, But There’s More to Sexual Health Than Preventing Pregnancy

Martha Kempner

I worry that in our excitement to promote long-active reversible contraceptives as an effective way of preventing teen pregnancy, members of the public will overlook the importance of sex education and the need for condoms.

Earlier this month, the Centers for Disease Control and Prevention (CDC) released a study that found more people ages 15-to-19 are using long acting reversible contraceptive (LARC) methods than in the past. That rate among young people, however, is still relatively low. The authors of the report join a chorus of public health experts in suggesting that further efforts be taken to increase access to and use of these methods throughout the country.

I worry that in our excitement to promote LARCs as an effective means of preventing teen pregnancy, we will overlook the importance of sex education and the need for condoms—both as an alternative, short-term form of contraception and to prevent sexually transmitted infections.

Contraceptive methods that are safe and highly effective are vital for preventing unwanted pregnancies, but there is more to sexual health than that.

The Methods

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

IUDs are small, T-shaped devices that are inserted into the uterus by a physician. They prevent pregnancy primarily by interfering with the path of the sperm toward the egg. Two of the IUDs on the market—Mirena and Skyla—release hormones similar to those in some birth control pills, which create a barrier to sperm by thickening the cervical mucus and may also prevent ovulation. The other type of IUD, called ParaGard, releases copper, which is thought to create an environment that is toxic to sperm. ParaGard lasts for ten years, Mirena for five, and Skyla (which is smaller and was introduced with young women in mind) for three, but any of them can be removed sooner if a user wishes to become pregnant or switch methods.

Contraceptive implants, sold under the brand name Nexplanon, are flexible plastic devices about the size of a matchstick that are inserted under the skin on a woman’s upper arm. Nexplanon releases hormones similar to those in birth control pills, which prevent ovulation and thicken cervical mucus. Nexplanon also lasts three years but can be removed earlier.

LARC methods have the highest efficacy rates against pregnancy, in large part because users can “set them and forget them,” so to speak. Unlike the birth control pill, which a woman has to take every day regardless of whether she has sex, or a condom, which couples must use each time they have sex, these methods work with no effort on the part of the user. This means that the typical-use efficacy rate (the one that shows how well the method usually works for a couple during the first year of use) is very similar to the perfect-use efficacy rate (the one that shows how well the method can work if used consistently and correctly).

IUDs have a failure rate of less than 1 percent; implants have a failure rate of 0.05 percent. In other words, out of 100 couples who use these methods as their primary form of birth control, fewer than one will experience an unintended pregnancy in the first year of use. In comparison, typical use rates for the pill suggest that nine couples out of 100 will experience an unintended pregnancy that first year.

Though IUDs were once thought to be safe only for older women or women who had already had children, research in the past decade has found that they are safe for women of all ages, including adolescents. Implants have also been found to be safe for women of all ages.

The Excitement

Given the safety and efficacy of these devices, it’s easy to see why so many experts feel that LARCs may help prevent teen pregnancy in the United States. After all, if a 16-year-old gets an IUD, there’s almost a guarantee that she won’t get pregnant until she’s 19 at the least.

As Rewire has reported, both the American Congress of Obstetricians and Gynecologists (ACOG) and the American Pediatric Association (APA) have suggested that LARC methods should be a first choice for young women.

ACOG writes:

When choosing contraceptive methods, adolescents should be encouraged to consider LARC methods. Intrauterine devices and the contraceptive implant are the best reversible methods for preventing unintended pregnancy, rapid repeat pregnancy, and abortion in young women.

The APA recommendations are similar:

Pediatricians should be able to educate adolescent patients about LARC methods including progestin implants and IUDs. Given the efficacy, safety, and ease of use, LARC methods should be considered first-line contraceptive choices for adolescents. Some pediatricians will choose to acquire the skills to provide these methods to adolescents. Those who do not should identify health care providers in their communities to whom patients can be referred.

And, this month’s CDC report will likely add to that excitement. The report looked at IUD and implant use among 15-to-19-year-old women who receive health care through Title X clinics. The Title X program provides family planning and related preventive health services for low-income individuals; it serves approximately one million teens nationwide each year.

The report found that among teens who sought contraceptive services at Title X sites, use of LARCs increased from less than 1 percent in 2005 to more than 7 percent in 2013. In 2013, roughly 3 percent of teens who sought contraceptive services used an IUD and 4 percent an implant. Teens older than 18 were more likely than 15-to-17-year-olds to use these methods.

The study also found that the use of LARCs varied widely across states. In Mississippi, for example, less than 1 percent of women ages 15-to-19 used LARCs, but in Colorado that percentage was up to over 28 percent. This finding is not surprising, as Colorado has implemented an initiative designed to improve LARC use among Title X clients.

The authors of the CDC study suggest that more programs like this are needed:

Given the estimated 4.4 million sexually experienced female teens in the United States, and the high effectiveness, safety and ease of using LARC, continued efforts are needed to increase access and availability of these methods for teens.

This month, the CDC also released a Vital Signs document about the key role that the government, health-care providers, and parents can take in helping teens prevent pregnancy. The document points out that about 43 percent of teens ages 15-to-19 have had sex and that four out of five used birth control the last time they had sex—but only 5 percent used “the most effective methods.” (This differs from the CDC study mentioned earlier because that study was limited to teens who sought contraceptive services through Title X providers.) The CDC suggests adults encourage teens to be abstinent, but also encourage the use of LARC methods when they become sexually active. It also suggests the government can help by funding programs, such as Colorado’s, to make such methods affordable and accessible.

The Concerns

While this push toward LARCs is indeed exciting, many public health experts and sexuality educators, myself included, worry that in our rush to promote them we will forget to discuss condoms—or worse, suggest that condoms are not good at preventing pregnancy. We have seen the manufacturers of other birth control methods, such as emergency contraception, throw condoms under the bus by suggesting they break easily. Similarly, the infographics accompanying the Vital Signs document depict the efficacy of various methods—LARC methods are at one end, with few pregnancies, and condoms are at the other, with many.

Though the information is not inaccurate, it does not contain the nuance needed to remind young people that condoms can work very well to prevent pregnancy but have a low typical use efficacy rate because people often make mistakes using condoms: Most notably, they don’t use one every time.

We know that young people often use condoms as their first method of birth control and that those who use them the first time are more likely to do so going forward. We also know that many people rely on condoms when they are in between relationships or in between other methods. This is encouraging for individual and public health reasons, and emphasizing condom failure runs counter to the goal.

And perhaps most importantly, condoms are the only birth control method that provide protection from STIs, for which we know adolescents are at high risk. Adults concerned about teens’ health need to stress dual use for young people: “Even if you or your girlfriend has a LARC, you should still be using condoms.” This will not only protect them from STIs now; it will help ensure their future fertility, as untreated STIs can compromise the ability to become pregnant later in life.

Deborah Arrindell of the American Sexual Health Association (ASHA) explained to Rewire:

LARC are a fantastic addition to the pregnancy prevention [resources]. But unless we are very intentional about promoting dual use of condoms and LARC, we leave young people at risk for HIV and other STIs. In fact, what young women do to prevent pregnancy now, may leave them exposed to complications from STIs that may prevent pregnancy when they want it. Maintaining good sexual health can be challenging, and we need to do everything we can to promote comprehensive messages.

As a sexuality educator, I must also say that I fear LARCs will be seen as a substitute for teaching young people about sex. Sexuality education is already controversial and undervalued. Even educators, advocates, and elected officials who support contraceptive-inclusive sexuality education often sell it primarily as a way to prevent teen pregnancy, because that is more politically expedient than arguing for knowledge for the sake of knowledge. But programs that start and stop with pregnancy prevention—or even STI prevention—don’t help teens understand the characteristics of healthy interactions, examine their own values around sexuality, and think critically about issues such as consent, gender roles, and sexual orientation. 

As Debra Hauser, president of Advocates for Youth, told Rewire:

There are no magic bullets. Young people who wish to use LARC should have confidential, low or no cost access. But LARC will not help reduce sexual assault or young people’s risk for STDs. Nor will LARC, in and of itself, promote healthy relationships. Enthusiasm for the effectiveness of LARC and its ability to prevent unplanned pregnancy should not usurp the importance of helping young people acquire the information and skills they need to develop agency and take personal responsibility for their sexual health and well-being.

Knowledge for the sake of knowledge is important if we want young people to grow up sexually healthy—to understand how their bodies work, have the skills they need to create and sustain good relationships, and make responsible decision about pregnancy and disease prevention. LARC methods can prevent pregnancy, but they can’t do anything else.

We can and should be enthusiastic about LARCs for teenagers. They are safe and highly effective and can help our young people prevent pregnancy in their teen years and beyond. But as we promote these methods and increase access to them, we have to remember to look at the whole picture of sexual health and make sure we do not sell our young people short.

Commentary Abortion

Men’s ‘Abortion Regret’ Stories Are More About Controlling Women

Amanda Marcotte

Anti-choice websites now promote male "abortion regret" stories—which are mostly an exercise in encouraging men to try to control women's bodies, even with bullying.

“Abortion regret” propaganda, which involves a handful of women declaring that their supposed remorse about their reproductive choices should mean fewer basic rights for the rest of us, was already nauseating enough. But if you’re really interested in vomiting in your mouth, I urge you to check out the growing tendency in anti-choice circles to bring men’s “abortion regret” to the forefront. Because the men were not actually in charge of the decision, these cases have even ickier connotations: that it’s somehow OK, and even desirable, for men to try to control women’s options.

The most recent example of such stomach-churning rhetoric is titled “The Apology,” produced by Heroic Media and discovered by Anna Merlan at Jezebel:

Freud famously posited that women suffer from penis envy, but this video demonstrates, conclusively, that the opposite is true: These cis men’s uterus envy has reached the level where they’re saying, “I had an abortion,” which is physically impossible for biological reasons. The whole video is underpinned with the belief that men should own women’s bodies so completely that even a woman’s experiences are assumed to belong to them—while the men themselves benefit from avoiding unwanted parenthood. It’s a win-win situation for these men, and the only thing they have to do is shed a few crocodile tears over their supposed “mistake” in not bullying the women they were dating into choosing to have a child.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Sadly, this video is not an anomaly. Websites like Reclaiming Fatherhood and Men Regret Lost Fatherhood cover the same basic territory: Men, who have the luxury of being able to live the lives they wanted because of abortion, claiming “regret” in order to steal that choice away from everyone else.

The irony here is that this focus on men appears to be motivated, in part, by the desire of the Christian right to shut down accusations of misogyny by instead framing abortion as something society, feminism, and careless men inflict on women. Those behind the narratives evidently want to dodge accusations of picking on women by placing the responsibility on men. They invoke images of chivalrous men dutifully marrying women they knock up, or, if not that, at least trying somehow to save the fetus with promises of help. The word “rescue”—both of the fetus and of the woman—is all over “The Apology.” Other sites focus on the idea that men can somehow stop abortion by being more invested in and more supportive of women they impregnate.

When you look more closely at the details, it becomes clear that what is being promoted here isn’t the gallant saving of grateful pregnant maidens, but rather a call for men to be domineering. “I should have manned up and I should have fought for you,” one man in the video says. “I was neither here nor there, so I never even fought for the opportunity to save the child,” says another. But we’re never given any indication of what this “fighting” might look like. We aren’t told much about how the women felt at all. That omission suggests the details are unsavory—that “fighting” looks less like the conservative ideal of heroically offering support, and more like haranguing and shaming women into having children for you.

When we dig into stories of male abortion regret at another site, Silent No More Awareness, the implications of emotional manipulation become even more obvious. One man whose girlfriend aborted and appears to have dumped him is angry that she hid the abortion, knowing that he’d try to stop her. Then he calls her a “dismal, heartless Cosmo girl” after she wises up and leaves him.

Another man, whose wife aborted because their marriage is on the rocks, uses the abortion as a pretense for relentlessly badgering and bullying her. “The estrangement is hard to fix and my wife can’t seem to share with me the horror and grief I still feel,” he writes. “She thinks I’m trying to instill guilt in her (but I wonder what she had done with her guilt feelings as a mother.)” For the record, I’m guessing she feels that way because that is exactly what he’s doing.

A third writes, about going to the abortion clinic, “We were there almost six hours waiting. I had a lot of ‘second’ thoughts during that wait. I knew deep down inside that what we were going to do was wrong, but at the time wasn’t strong enough to get up and walk out.” I doubt he is really confused about whose body needed to be there to get the abortion; after all, his girlfriend could have still gotten the procedure without him there. This suggests, then, that what he really regrets is not stomping out in a rage in an attempt to change his partner’s mind.

For a movement apparently trying to avoid charges of misogyny, it’s odd to see anti-choicers highlighting stories of men who wish they’d been bigger assholes to women.

But even if they really were just encouraging men to try to “rescue” pregnant women with offers of marriage, there’s a real flaw in many of these abortion regret stories. If getting married to the woman and having children with her was, in fact, the right choice, it’s hard not to ask why they didn’t go on to do just that. Deciding not to get married and have a child is one of those regrets that is easy to remedy! All you need to do is get married and have a child.

The fact that these men have almost never done that with the women they felt destined to breed with suggests that it was not, in fact, meant to be—either because they didn’t want it, the woman didn’t want it, or both. But they’re still so committed to the general idea that other men should force this on women that these kinds of obvious objections get ignored.

Because of all this, it’s hard to shake the feeling that this “men regret abortion” thing is less about “life” and more about reinforcing the idea that men should control women. Sometimes it’s through feints of chivalry, and sometimes through outright emotional manipulation, but it always comes back to the same idea: that women are not to be trusted to make their own decisions, so men should do it for them.