I’m pro-life: in favor of Medicare for all, a healthy environment, and gun control

I’m pro-life for adults and for later-term fetuses, but I’m pro-choice for early-term fetuses.  However, it seems that many conservative Americans are pro-life only for fetuses but not so much for children and adults.

Real pro-life includes everyone, not just fetuses. So, I’m in favor of government-guaranteed medical care for everyone.  And I’m in favor of stringent environmental regulations.

Here are some links about how harmful auto and truck traffic are to human health.

Many daycare centers and schools are dangerously close to busy roads.

Living near highways bad for lungs

Living close to a major roadway could increase dementia, study says

Roads are harmful to pregnant women

Road pollution associated with increased breast cancer

Road pollution bad for heart health

Then there are the indisputable negative effects of carbon pollution on the climate change.

How to Use the Bible against Abortion Protestors

It’s time to confront conception obsessed Bible-believers on their own terms, with language they understand.

Imaabortion-obama-jesusgine if we turned the Bible and Christianity’s highest values back on the Religious Right. This Saturday, February 11, the most conception-obsessed members of the Religious Right will be gathering at Evangelical and Catholic churches, loading teenagers into busses and cars, and surrounding Planned Parenthood with protest signs. Some will pray and sing church songs or shout Bible quotes or carry pictures of the Virgin Mary. But most will carry signs that say things like “abortion stops a beating heart” [so does oyster-eating] or “aren’t you glad your mother didn’t have an abortion?” [Yes; glad also that she didn’t have a headache that night] or “it’s a baby” [an acorn is an oak tree?] or “one life ended, one destroyed” [actually, factually not]. Some may carry “fetal squish” pictures—not  images of common early abortions but of the rare fetus that dies or is aborted late in gestation. In other words, they will try to sway the rest of us by speaking our language—the language of science, human rights and secular ethical values; and they will appeal to our moral emotions: compassion, love of life, and disgust.

Those of us who cherish the freedom to choose our own lives and families—and to live by our own moral values—could learn a thing or two from the more sophisticated of these protestors, both what they say and what they want to hide.

  1. They want us to think that it’s not about religion. Despite the smattering of non-religious opponents, it is. Ignoring this means we constantly fight a defensive battle on our turf, not theirs. Key take-away: Define this as a fight about theology, which is what it is. Use theological terms that are Christianity’s insider jargon and quote the Bible.
  2. They want us to think that they are on the side of women, that their stance against abortion comes from a deep place of love and concern. It doesn’t. Their conception obsession is deeply rooted in misogyny, and concern for women is a thin veneer. Here is what the anti-abortion movement would look like if it were driven by love. Key take-away: Expose the deep underlying religiously-motivated disdain for women. Quote degrading Bible verses, church fathers and modern pastors.
  3. By trademarking the term “pro-life,” abortion foes try to stake out the highest of the moral high ground. They don’t have it. Their crass indifference to the lives around them—to the wellbeing of both vulnerable people and even the whole web of life—shows their self-appointed title as defenders of “life” to be total bullshit. Key take-away: Shine a light on self-righteous hypocrisy. Expose the Religious Right’s indifference to Christianity’s own highest values, including compassion and reverence for life.

I said that abortion foes try to speak to us in language we understand, by appealing to our sources of authority, science and conscience. When we appeal to people who are on our side or neutral or secular, we should do the same. We must work to end abortion shame and stigma, to convey that abortion is normal and that family planning as a whole—including abortion until it becomes obsolete (we are headed that direction)—is a positive social good.

But when it comes to confronting and neutralizing abortion protests, we should attack the home turf of the abortion foes, not defend our own turf. We should speak in language of the protesters and convey that their position is a threat to their own core values. (Remember, this is what they do to move us.)

At the same time, they are playing to a broader audience, and we can, too. To outsiders, we can neutralize the tradition of incessant clinic protest by framing it as a theological dispute (most people want to keep theology out of healthcare), that is driven by archaic, ugly gender scripts (no thanks!), and that is being played out by people who have little moral credibility (everyone hates a mean-spirited, self-righteous hypocrite).

Here are a few examples of what the counter-protest signs might look like. *Some may make sense only to Christians and former Christians. **Thank you to all the former Bible-believers who offered suggestions on Facebook. ***If you have ideas of your own as you read the list, please add them in the comment section.

Define this as an insider dispute about theology

  • God aborts 60%. Who are you to judge the Almighty?
  • Fact checked: The Lord says he’s ok with it
  • God prescribes abortion potion – Numbers 5:22-27
  • Kill fetus, get fined – Kill woman, get death –Exodus 21:22-23
  • Infant becomes person after birth – Leviticus 27:6
  • Fetus fetish is idolatry
  • This is what bibliolatry does to people →
  • Conception obsession is a religious cult
  • Don’t say you follow Jesus if stopping abortion trumps love, truth, peacemaking, compassion, feeding the hungry, caring for the poor . . .
  • Life begins at ejaculation – Ask Onan
  • If the baby goes to heaven And the doctor goes to hell If the woman gets forgiveness What’s the problem pray tell!?
  • The Bible doesn’t define when life becomes “a living soul.” Don’t put your words in God’s mouth

Expose deep underlying misogyny

  • Wife is man’s property – Exodus 20:17
  • Girl babies twice as unclean as boys – Leviticus 12:1-8
  • Women should keep silent – 1 Cor. 14:34
  • Sell raped daughter to rapist – Deut. 22:28-29
  • Female? Cover your head or cut off your hair – I Cor. 11:6 [with picture of hijab]
  • Women will be saved through childbearing – 1 Tim. 2:15
  • Women make men dirty – Rev 14:4
  • Woman is a temple built over a sewer – Tertullian
  • Woman, you are the gate to hell – Tertullian
  • Man alone is the image of God – Saint Augustine
  • I fail to see what use woman can be to man, if one excludes the function of bearing children. –Saint Augustine
  • Woman has a faulty and defective nature – Saint Albertus Magnus
  • The production of woman comes from a defect – Thomas Acquinas
  • Women were made to be either wives or prostitutes – Martin Luther
  • The second duty of the wife is constant obedience and subjection – John Dod, Puritan
  • Women are made to be led, and counseled, and directed – LDS Apostle Herber Kimball
  • Every single book in your Bible was written by a man – Mark Driscoll

Shine a light on self-righteous (religious) hypocrisy

  • Pro-guns, pro-greed, pro-Trump = “pro-life” Hmmm. Woe to you, Pharisees, hypocrites! Woe to you, Pharisees, hypocrites Woe to you, Pharisees, hypocrites Woe to you, Pharisees, hypocrites
  • ”Pro-life” Trump Hypocrites =“False prophets, ravening wolves” – Jesus
  • Woe to you Pharisees, hypocrites! — Jesus
  • Pharisees →
  • Take the log out of your own eye –Jesus
  • Judge not that ye be not judged – Jesus
  • [picture of immigrant child] – Let the children come unto me—Jesus
  • Jesus focused on real people
  • Pro-fetus, against Child Protection
  • Pro-fetus, oppose rights for children
  • Pro-fetus, defend parent right to hit kids
  • Pro-fetus, against UN Convention on the Rights of the Child
  • I was hungry and you did not feed me – Jesus If a man says ‘I love God’ and hateth his brother, he is a liar- 1 John 4:20
  • Jesus supported healthcare for women
  • Jesus cared for women, no matter what [echoes Planned Parenthood motto]
  • The screwed-up priorities of “pro-life” Christians kill real children
  • Trump Voter? Don’t talk to me about choosing life
  • Voted for Trump? Maybe that’s not the voice of God you are hearing

Planned Parenthood doesn’t organize counter-protests, because they don’t want to escalate conflict and because they have a job to do providing contraceptives, cancer screenings, STI tests, abortions and other basic healthcare for their patients. They have no desire to get involved in theological disputes. But I think it’s time for the rest of America, meaning religious moderates and non-religious Americans, to go on the offense against the Religious Right. For decades now—really, ever since Roe v Wade–we’ve been playing way too nice.

At some point in the future, pregnancy almost always will happen by mutual consent of two people who want to co-create a child. But we’re not there yet, in large part because patriarchal religious conservatives have opposed sexual health literacy and better birth control every step of the way. Right now, we could make elective abortion virtually obsolete if the Religious Right had any interest in doing so. They don’t. That means, for now, the only way that young men and women can live the lives of their choosing and form the families of their choosing and stack the odds in favor of flourishing children—is to have access to abortion so they can end ill-conceived pregnancies.

The Left has been squishy and apologetic about abortion care—leaving providers unprotected, and allowing brave, prudent young women to be shamed for making the best decisions they could under difficult circumstances. We’ve let the Religious Right bully all of us, including moderate Christians, into doubting our own moral convictions.

Sometimes, the only way to stop a bully is to hit back. In the spirit of courageous, unflinching, nonviolent resistance, we need to figure out together what that means. So, don’t forget to share your thoughts.

Oh, and if you decide to counter-protest on Saturday, remember that while you are taking a stand on behalf of women and families, Planned Parenthood employees will be serving them. Don’t interfere with traffic, stay away from the entry, keep off private property, and silently let your sign do the talking for you. Don’t distract from the ugly behavior of the Religious Right by engaging in ugly behavior of your own. You are a role model for any children and teens who have been dragged along; be the change fundamentalist parents don’t want their kids to see in the world.

Originally posted at ValerieTarico.com

Dems should support a grand compromise involving reasonable restrictions on late-term abortions

Alternative titles for this essay:

    • “The natural attitude: pro-choice at conception, pro-life at term.”
    • “Late-term abortions are rare and morally suspect. Compromise!”
    • “I’m pro-choice, but not for late-term fetuses.”
    • “A commonsense compromise on late-term abortions”
    • (if I want to pick a fight): “How Pro-Choice Extremists Sabotaged the Democratic Party.”

Are you okay with on-demand abortions late in pregnancy, say in the eighth or ninth month?

The question is almost absurd, for three reasons.

First, such abortions are rare.

Second, no woman would want such a late-term abortion except for a very good reason, such as her health being at risk, or rape.

Third, the fetus is usually viable and has a highly developed nervous system, so chances are you are not comfortable with such late-term abortions.

For these reasons, and because Democrats keep losing elections, Democrats should support a grand compromise: reasonable restrictions on late-term abortions, in exchange, say, for reasonable restrictions on gun rights or, better yet, guaranteed health care for all — something that pro-life people should support.

Many Democrats and women will be outraged at this suggestion, but when you think about the facts, you realize that it’s an obvious step that would help the Democrats at very low cost.

Conservatives like to use purported examples of late-term abortions to illustrate the immorality of abortion.  And Democrats seem unwilling to compromise on the issue. But late-term abortions are extremely rare.

“Of the 1.6 million abortions performed in the U.S. each year, 91 percent are performed during the first trimester (12 or fewer weeks’ gestation); 9 percent are performed in the second trimester (24 or fewer weeks’ gestation); and only about 100 are performed in the third trimester (more than 24 weeks’ gestation).” (source: Fast Facts: U.S. Abortion Statistics)Likewise, “just 1.3 percent of abortions took place at or after 21 weeks pregnancy.” (source)

Data for other countries are similar.

Only four doctors openly perform late-term abortions in the U.S.

Not only are late-term abortions rare. They’re also restricted already. According to Late-Term Abortions Are Rare and ‘Partial Birth Abortions’ Illegal. Why Do They Keep Dominating the Reproductive-Rights Debate?, in 43 U.S. state “abortion is banned—with limited exceptions, such as for the safety of the mother—after the second trimester, after the point of fetal viability (when a fetus could live on its own outside the womb), or after a specified number of weeks (generally 20-24). When exceptions are required, many states require two physicians to sign-off on the procedure before it’s permissable [sic].”

In 2013 the House of Representatives passed a bill to outlaw abortions after 20 weeks, except in cases of rape, incest, and where the health of the woman is endangered. The Senate refused to consider the legislation and President Obama said he’d veto it.

In January of 2017, the U.S. Senate failed to pass a late-term abortion ban. As the New York Times reports

The Senate rejected a bill on Monday to ban most abortions after 20 weeks of pregnancy, a largely symbolic vote aimed at forcing vulnerable Democrats to take a stand that could hurt their prospects for re-election in states won by President Trump.

By a vote of 51 to 46, the measure fell well short of the 60-vote threshold required for the Senate to break a Democratic filibuster. The outcome was not a surprise, and the vote fell mostly along party lines.

But the article goes on to report: “The United States is one of just seven countries — including China and North Korea — that permit elective abortion after 20 weeks, a fact that backers of the failed measure brought up repeatedly on Monday.”

The Supreme Court ruled that while abortion is a constitutional right, the right is not absolute and states can restrict late-term abortions provided they make exceptions for the life and health of a woman and provided the doctor gets to decide what constitutes health, including mental health.  “Although the vast majority of states restrict later-term abortions, many of these restrictions have been struck down….Nonetheless, statutes conflicting with the Supreme Court’s requirements remain on the books in some states.”  (source)

Because late-term abortions are so rare, because late-term fetuses are viable and presumably have feelings, because late-term abortions are already highly restricted, because tens of millions of voters think abortion is a sin and so vote Republican,  abortion rights supporters should be willing to accept national restrictions on such abortions, provided there are exceptions for the health of the mother and for rape and incest.

One can and should quibble on whether 20 weeks was the correct cutoff — 24 weeks might be more reasonable — and one can quibble over whether pregnancy is measured from the last menstrual period or from the date of likely fertilization. And one can quibble about what constitutes the health of the woman. But it sure seems that compromising on this issue would be a reasonable choice, given all the other issues and seats that are at stake in elections, and given the fact that there are so few late-term abortions.

I’ve spoken to conservatives who say they’d gladly vote for Democrats but for this one issue: abortion.

In Why Abortion isn’t Murder I argued at length that until the embryo has a highly developed nervous system, there’s “nobody home” — no consciousness — and so abortion is not the destruction of a person. When I showed that article to some abortion rights activists, they were skeptical. They were uncomfortable with an argument based on consciousness because, they rightly saw, it logically leads to a position in which there are restrictions on late-term abortions.  Abortion rights activists prefer an argument based on privacy rights: a woman should have absolute control over her own body.

According to a 2012 Gallup poll, only 14% of respondents think that third-trimester abortions should be legal.

What are the risks for Democrats of compromising on this issue? First, the haggling over the cutoff date — 24 weeks? 20 weeks? — could be ugly. Second, it’s unclear how many votes it would win in elections, because voters are so brainwashed and uninformed.  (For example, they blame Democrats for the deficits when it’s the Republicans who are much more responsible.) Third, conservatives may use the compromise as an excuse for demanding tighter restrictions on abortions.

Perhaps some of my feminist friends will be upset with me because of this stance.  Besides, they may say, I am not a woman, so I have no right to state my opinion.

But face the facts. Trump won; a majority of white female voters voted for him. Republicans control the House, the Senate, and a majority of legislatures and governorships. Soon they may have overwhelming control the Supreme Court. Politics requires compromise.  For tens of millions of Americans, abortion is a moral outrage and is the defining factor on how they vote.  Late-term abortions are rare.  Are you comfortable aborting a nine month old fetus?  Reasonable restrictions on late-term abortions are a worthwhile compromise, if that’s what it takes to avoid GOP control of all levels of government, and if that what it takes to win on other issues dear to progressives.

Chris Hedges suggests a similar position in his article The Coming Collapse. He writes, “It [the Democratic Party] plays to the margins, especially in election seasons, refusing to address substantive political and social problems and instead focusing on narrow cultural issues like gay rights, abortion and gun control in our peculiar species of anti-politics.” (my emphasis)

Reasonable restrictions on late-term abortions are like reasonable restrictions on guns: something that a vast majority of people want but that political extremism makes very hard to enact.


Peeling Back the Polished Pro-Woman Surface of Prolife™ Rhetoric

anti-abortion-protesterProlife leaders trying to convince the world that they are actually pro-woman have failed to convince even their own followers.

For years now, the professional class of abortion foes has been working to polish the Prolife brand, claiming that they are not mere fetal fetishists but actually protectors of women, who are being exploited by profit-hungry abortion doctors. They bolster their pro-woman positioning with false claims that abortion causes cancer (it doesn’t), or sterility (it doesn’t), or death (it’s a hundred times safer than carrying a pregnancy to term), or that women regret their abortions and suffer depression (as with any major life decision, some do; but most experience relief).

Even ignoring the disinformation, just beneath the thin layer of chivalry lies a toxic stew of religion, sexism, and judgmental certitude. Religious right politicians seeking to regulate abortion out of existence with bogus safety laws may have memorized their lines, but rank-and-file believers keep saying what they really think.

The Comment Thread Conundrum

Like most writers, I send articles to a variety of outlets, but I also cross-post to my own website, where religious conservatives and abortion foes not infrequently send me an unedited earful. (Do the people ranting or even making threats not realize that I have editorial control at my own site?) I don’t always publish such comments, but I do keep them, in part because they so clearly illustrate the dark underbelly of religious conservatism and its obsession with controlling sex and reproduction.

Consider a few of the recent tidbits:

  • “These clinics are greedy and if a woman leaves there is no profit for them. Most of these women could meet a mother that desperately wants a child and would provide their baby with a great life, but these women are too self-absorbed to care about that. These women don’t want anyone knowing they were pregnant and gave their baby up, they would rather murder their child to save face.”
  • “Sorry but nothing justifies abortion that’s why god condemns premarital sex in the first place because of its consequences if everybody obeyed gods rules instead of doing what they want there would not be any unwanted pregnancies or children being born out of wedlock or any other things I doubt that the majority of abortions are of women use birth control and the birth control failed that’s why the bible says that are going to see good as something bad and the bad as something good that’s why the world is so messed up today because the wicked one is misleading the entire earth.”
  • “You are nothing but a wicked woman who loves to murder babies. You are a Satanist, a Devil worshipper. I pray for you to trust in Jesus and be saved, Valerie. I pity you because you will one day face a HOLY GOD named the LORD JESUS CHRIST who created those babies and those children who you advocate for the mass murder of. To support abortion, aka, baby slaughter, baby murder, is to be complicit in it. God can forgive you if you will trust in His eternal Son the Lord Jesus Christ and His shed blood atonement alone, Valerie.”
  • “Abortion should be illegal and the participants charged with murder and punished.”
  • “Shooting an abortionist is as “wrong” as shooting a sniper on the roof of a school, you do what you have to do to save the lives of children, both born and unborn.”

Once Set in Motion . . . .

Prolife™ leaders may cringe and seek to distance themselves from comments like these, or from the prayer circles and rosaries and gauntlet of hell-threats outside of abortion clinics—or worse, from stochastic terrorism like the murders at Colorado’s Planned Parenthood. But ordinary Evangelicals and conservative Catholics really can’t be blamed for their difficulty in getting the branding right.

Many have been taught from childhood that every fetus is a teeny weeny baby, and that God values each from the moment of conception. Scientifically or statistically this may be implausible, but it’s black and white, beyond question like other points of theology. Some abortion opponents—most—retain an intuitive sense that the difference between an embryo and a child is morally consequential. But others simply follow that line of thinking to its logical conclusion: An abortion provider is a sniper on a school roof. A woman aborting a pregnancy might as well be drowning her preschooler in a bathtub. The only possible explanation is that those who disagree lack morals or are in the thrall of Satan.

The Fruit of the Prolife Spirit

One of the New Testament writers made the mistake of saying that Christians would be known by their “fruit,” meaning their actions and the consequences of those actions. If this is the case, the motives and morality of ProLifeTM Christians are laid bare not only by their own ugly words and behavior but by the fruit of their relentless, obsessive campaign to obstruct abortion access while simultaneously denying prospective parents the information and contraceptives needed to time their pregnancies. Pro-woman? Guess again.

  • Over 200 women in the U.S.—and over 200,000 globally—dead each year from an unsought pregnancy.
  • Millions more with permanent changes to health or mental health.
  • Pregnant teens and young women forced to drop out of school, floundering for years or decades instead of flourishing.
  • Fragile families locked into deeper poverty by mistimed and unwanted fertility.

Underlying all of this is the foundational assumption that women don’t know what is best for them and their families, can’t know what is best, can’t be trusted as autonomous moral agents—which is why God put men in charge. Women were made for childbearing. The Bible says so!

Not Gender Justice, Not Social Justice

If there’s one thing that can be said for the ancient texts gathered in the Bible, it is that many of them have a strong social justice message. Prolife leaders, recognizing this, often claim that they are advocating justice for the most vulnerable members of society, which includes children and racial minorities as well as women. They relentlessly link abortion with genocide or with the misguided eugenics push of the early 20th Century, proclaiming for example that Black babies are in particular danger of being aborted. (Poor Black women do abort somewhat more than white women but also carry more pregnancies forward because of a higher rate of pregnancy.)

In reality, families living at the hardscrabble edges of life are those most negatively affected by the Religious Right’s obstruction of family planning services.

I was in Singapore when my husband and I discovered that my first trimester pregnancy was infected with Toxoplasmosis. The consequences can be much like Zika, so we decided to abort and start over; and we received supportive, competent abortion care from a Singaporean doctor trained in Canada. Had timely care not been available in Singapore, we could have gone wherever we needed. Our privileged reality is inconceivable for most couples or women facing an ill-timed or unhealthy pregnancy.

Abortions have always been more available to upper and middle class couples than families struggling to get by. Knowing that they can’t control women of means, the Religious Right has doubled down on poor women who rely on public healthcare services, denying them insurance coverage and forcing on them long distance travel and childcare costs that [abortion foes hope will] become insurmountable barriers. In the Pacific Northwest, poor women in need of abortion turn to complete strangers for financial support via a program known as the CAIR Project, one of several “underground railroads” providing housing, transportation and funding for women in need.

Nationally, advocates for poor women and families are fighting through the coordinated campaign All* Above All to overturn the Hyde Amendment, which for 40 years has stripped abortion coverage out of Medicaid. Women of color—long denied the full right to manage their own fertility and disproportionately impacted by this restriction—are taking the lead.

Pro Woman, Pro Family, Pro Child

Not all women and men want children, but for all of us decisions about parenthood are among the most important and life-shaping choices we will ever make.

As parents, we all want to stack the odds in favor of our children flourishing. Those who can, seek prenatal and pediatric care, and provide nutritious food, and read stories, and help with homework, and get up bleary-eyed and go to work, and sock away a little financial buffer. Even men and women whose lives are destitute or desperate, or who are plagued with illness or mental illness, want what is best for their kids.

Religious rhetoric aside, we all know that parenting begins before conception, not at some magical moment when a sperm penetrates an egg. We know that the timing and circumstances of birth can shape the course of a child’s life. Mindful of our own limits, most of us try to time and limit our pregnancies, and we sometimes end them, so that we can bring our kids into the world under the best possible conditions available to us, with enough bounty to thrive.

Real pro-life passion is more than just lipstick on a pig in a clerical collar. It means thinking about what makes life so precious to all of us, regardless of our religion or circumstances. It means doing what we can to create genuine reproductive empowerment so that perhaps, someday, all children will come into loving families who are ready to welcome them with open arms.

Originally published at ValerieTarico.com

Republican Talking Heads Claim Talk has no Power to Influence Beliefs and Behavior

Who incited Christian terrorism?  Not me.  Couldn’t be.

In what could be the greatest hypocrisy in a season of head-spinners, Christianist Republicans—from presidential candidates to congressmen to Fox News bimbos to sleazy video-splicers and wild-eyed sidewalk ranters-with-rosaries—are scrambling to deny that what they say actually matters.

Specifically they claim that they had nothing to do with a shooting rampage at Planned Parenthood in Colorado Springs.

Never mind that conservative Christians in high places have been fanning flames for months, calling women and care providers murderers, pretending to believe Planned Parenthood kills big-eyed babies and sells body parts for profit. Never mind that we call such language “incendiary” because it is incendiary. They are shocked-shocked-I-say, that some wingnut in Colorado actually took their becking at face value and opened fire in a family planning clinic.  Who could have possibly known that all that posturing and lying for political gain might affect someone’s behavior?!  Uh, I mean, it didn’t! It couldn’t. It was just talk!

Did anyone other than the guilty parties themselves fail to notice the bizarre irony here?  The people now hastening to assure us that talk doesn’t matter are people who earn big salaries talking. We refer to them as talking heads because that’s what they do, day in and day out, month in and month out.  Talk, talk, talk. Why?  Because like all bullies they (and the folks who bankroll them) are betting that words actually can hurt you.

Those most carefully denying any relation between talk and murder are politicians who spend years speechifying in order to change voter behavior, assisted by well-paid communications experts who the big bucks because tweaking words slightly might affect what voters do. They are pulpit pounders who siphon off 10 percent of churchgoer earnings on the premise that by talking to and for God they can influence beliefs, attitudes and behavior. Talk can save souls. In fact, in the Iron Age mythology of the Bible, it can bring whole worlds into existence.  In the beginning was the word. 

But a bloodbath incited by mere words? Stochastic terrorism? A crazy lone wolf who reacts predictably to the fear and fury of the pack? Words erupting into violent action and reaction? Words shattering into the staccato of gun fire, into screams of terror and anguish? Words slurring into the soft gurgle of the dying? Couldn’t be.

Someone should tell America’s politicians, ad men, preachers and campaign consultants to pack up and get jobs where they actually have some influence. If, as they claim, they’re not capable of getting one crazed wingnut among millions to pick up a gun and open fire after months of professionally crafted goading and millions of dollars of airtime, they don’t deserve their big salaries.

Originally published at ValerieTarico.com

Will At-Home Therapeutic Miscarriage Make Abortion Clinics Obsolete?

Medication abortionAt the turn of the millennium, the FDA approved a pill that could replace most abortions with early at-home therapeutic miscarriage.  When will that potential be realized? 

Fifteen years ago, in September of the year 2000, the FDA approved a French pill known at the time as RU-486 that offered women a safe, inexpensive alternative to clinic-based abortion. Better known by the name mifepristone or mife (rhymes with spiffy), the pill triggers the body’s natural process for rejecting an ill-conceived pregnancy.

When a woman’s reproductive system is working normally, most fertilized eggs either fail to implant or spontaneously abort—a process designed to cull pregnancies that are unlikely to produce healthy babies. This natural process of spontaneous abortion (the medical term for miscarriage) is imperfect, but it stacks the odds in favor of thriving children and families. Therapeutic miscarriage, which has the same goal, makes the process voluntary, allowing rational decision-making to enter the equation.

After mife blocks the hormone progesterone, the lining of a woman’s uterus releases any attached embryonic sac and begins a shedding cycle. Coupled with a second medication, misoprostol, mife provides the most effective means of ending a pregnancy prior to seven weeks and it works well throughout the first trimester. For most women, the experience is like a very bad menstrual period—the kind with cramps, clots, heavy bleeding, nausea and so forth—definitely unpleasant but within the range of normal.  (True fact: Many times when a woman experiences unusually heavy period cramps and bleeding she is going through an early, spontaneous abortion.)

Dire Predictions and High Hopes

At the time mife came on the market, conservative Christians warned that it would increase the number of abortions.  It hasn’t. Health advocates predicted that it would replace clinic-based abortion with early, at-home therapeutic miscarriage. That hasn’t happened either. Today, mife is used for a third of U.S. abortions up to nine weeks, with most women still relying on clinic-based procedures. But medical experts believe that the potential of mife is largely unrealized—that many of today’s abortion procedures could be replaced by earlier, less intrusive, and less expensive at-home therapeutic miscarriage.

Safety not the Barrier 

To date, more than two million American women have used mife to end an unwanted pregnancy. The drug was approved in France in 1988 and is now used globally for early pregnancy termination; a quarter century of data show that it is highly safe and effective. In about two percent of cases the medication fails to cause a complete abortion and the woman requires an aspiration procedure—as can happen with spontaneous miscarriage as well.  About 4 in 1000 women will experience a serious infection or blood loss that requires hospital treatment, a rate that is much lower than comparable risk associated with full-term pregnancy.

Improvement in Clinic-based Abortion  

One reason that many women prefer to simply schedule an abortion is that abortion procedures themselves have improved significantly in the last generation. A retired Seattle doctor tells the story of a young woman decades ago who asked partway through her abortion, “Where are the whirring blades?” The doctor marveled at the patient’s courage and determination—she had scheduled and gone through with the procedure despite thinking that “whirring blades” were somehow involved—but assured her that the then-standard D&C required no such thing.

Today the D&C itself isn’t required for a first trimester abortion, which typically extracts an egg sac smaller and softer than a cherry.  An early abortion procedure can be completed with a small disposable hand-held aspirator, not quite as simple or cheap as a turkey baster, but operating on the same principle. In contrast to an induced miscarriage, which takes place over the course of several days, the aspiration procedure can be as short as ten minutes. That makes it an important option for women who, once their minds are made up, simply prefer to get the procedure done.

Obstruction and Unnecessary Restrictions 

Some women may always prefer a quick clinic-based procedure over an at-home process that takes several days, however private and convenient the latter may be.  But the main reason many choose clinic-based abortion procedures today is that conservative politicians have erected a barricade of “health regulations” that have nothing to do with health and everything to do with obstructing access to misoprostol.  These regulations take what should be a simple prescription—take 1 pill this afternoon and 4 tomorrow and call if you have any concerns—and turn it into a regimen that is complicated, expensive, and difficult to access. That is their purpose. They also cause women to delay abortions past the window in which at-home therapeutic miscarriage would be safe and effective, forcing them to seek later, clinic-based procedures.

The rules now regulating misoprostol have turned what should be an evaluation, followed by at-home pill-swallowing and self-monitoring, into a process that is every bit as cumbersome as outpatient surgery. Depending on state rules:

  • A woman may be required to make multiple clinic visits days apart.
  • She may be required to actually swallow the pills in the presence of a physician.
  • A doctor may be forced to prescribe more medication than is necessary, based on an outdated procedure with more side effects.
  • Advanced practice clinicians like physician’s assistants and nurse practitioners may be barred from assessing pregnancy status or administering mife and misoprostol, even though World Health Organization guidelines and research indicate that they are perfectly qualified to do so.
  • The office in which the medications are given may be required to have an operating suite and halls in which two gurneys can pass, even though no surgery is being performed there.
  • The doctor may be required to watch the patient swallow the pills in the operating theater.
  • Telemedicine prescribing of mife may be specifically prohibited by law, even though this has been shown to be a safe and effective option for women in rural and underserved communities and to drop the number of second trimester abortions.

In sum, women don’t opt for early at-home therapeutic miscarriage because it is not available to them as an option.

Looking to the Future

Would more women choose at-home miscarriage over clinic-based abortion procedures if obstructions were removed? Certainly religious conservatives think so, or they would not have introduced hundreds of obstructive laws in recent years with the goal of forcing women to undergo more appointments and procedures in order to end a pregnancy. Self-proclaimed abortion foes who publicly talk about viability and fetal pain show little interest in helping women transition from later to earlier terminations, those that take place at the embryonic “lentil” or “bean” stage, long before pain or viability becomes a question.

Nor do they show any interest in preventing the unwanted pregnancies that lead to abortion. Today’s top tier contraceptives drop the abortion rate by over ninety percent. In a St. Louis study of nearly 10,000 women, the percentage drop in abortions almost perfectly matched the percentage of women who switched to long-acting “set and forget” contraceptives. I have written elsewhere about what a serious anti-abortion movement would look like—and how it would leverage advances in pregnancy prevention. But given a choice between clinic-based abortion and pregnancy prevention, self-proclaimed abortion foes choose more abortion every time. The recent attempt to defund everything that Planned Parenthood does except abortion care speaks for itself.

One great irony of the culture wars is that the most staunch defenders and providers of abortion care are also those doing the most to make abortion need dwindle into history, while the most staunch critics disdain and discredit family planning technologies and undermine access—driving demand for clinic-based abortion in an all-or-nothing bid to control female sexuality. But despite the obstructions, word has gotten out that women have options; and despite obstacles, women seek them out—determined to live the lives of their choosing and to stack the odds in favor of their children, their families, and our world. Despite—not because of— conservative obstructionism, both unintended births and abortions are declining as reproductive empowerment grows.

Dr. Daniel Grossman of Advancing New Standards in Reproductive Health, a research program at the University of California, San Francisco, is a tireless advocate for options including over-the-counter birth control pills, emergency contraception, “set and forget” IUDs and implants, and—when all else fails—abortion care.  He shares one opinion in common with his conservative opponents:  If obstacles are removed, more women will choose the privacy and convenience of at-home therapeutic miscarriage over clinic-based abortion. “What is the ideal ‘perfect’ proportion of medication abortion?” Grossman asks. He goes on to say, “We don’t know.  I think if women are given a true choice, at least half of eligible abortions would be medication abortion.”

One pill the first day, four to follow, have someone pamper you, pay attention to how you feel, call me. 

Will that put abortion clinics out of business? Not in the near term.

But in the long run, the men and women now providing abortion care may find themselves increasingly able to devote their energy to pregnancy planning and prenatal services. Clinic-based abortion procedures likely will dwindle as more women have access to at-home therapeutic miscarriage. Add that to the fact that abortions of all kinds will plummet as young women switch over to IUDs and implants—and by 2030, the familiar 1-in-3 statistic and the stand-alone abortion clinic may be a distant memory.

Originally published at ValerieTarico.com

If the Anti-Abortion Frenzy Were Actually about Abortion . . . What a Serious Anti-Abortion Movement Would Actually Look Like

Forty years after Roe v. Wade, the Pro-life movement is a radical failure by the very metrics that abortion foes cite to inspire their base. What would a real anti-abortion movement look like?

U.S. women have obtained nearly 53 million legal abortions since 1973. That is because self-described abortion foes ignore or oppose the most powerful strategies for making abortion obsolete. The anti-abortion movement is dominated by religious fundamentalists whose determination to control sex—who has it, with whom, for what purpose—takes priority over their desire to reduce abortions. This focus has seriously interfered with eliminating the supply and demand for abortion services.

If the top priority of the Pro-life movement actually were to end abortion, both tactics and results would be radically different. Imagine a fictional person whose chief life goal is to reduce abortion by, say, 90 percent over the next twenty years. This person might devoutly believe that every fertilized egg has a soul and that fetal demise is a tragedy; or he/she might simply think that abortion is an expensive, invasive, emotionally-complex medical procedure that should be made obsolete. Either way, this person believes that moving society beyond abortion is the most valuable cause to which he or she can devote a lifetime.

It might come as a surprise to the audience of today’s anti-abortion theater—but our protagonist’s goal is attainable. Armed with just the information and technologies available today, someone genuinely committed to reducing abortion by 90 percent in 20 years could map out a plan to get there—and even make people’s lives better in the process.

Skeptical? Let me map it out. When someone gets serious about building an effective beyond-abortion campaign the strategic plan will look something like this:

Serious beyond-abortion advocates will ensure that all Americans have the knowledge and means to prevent the kind of pregnancies that lead to abortion.  

    1. Since many parents had poor role models for birds and bees conversations, serious anti-abortion activists will promote programs that help parents to overcome discomfort and create healthy, age-appropriate conversations about genitalia, sexual health, sexual pleasure, intimacy and reproduction.

      Conversations between children and trusted adults delay the onset of sexual activity while increasing the percent of sexually-active teens who protect themselves against unwanted pregnancy (and so the need for abortion). Therefore, serious anti-abortion activists will help parents build trust and credibility on sexual matters. Despite the discomfort of aging traditionalists, who might prefer to avoid frank conversations about sex, serious anti-abortion activists will keep their eye on their prize, which is fewer abortions.
    2. Since preventing abortion is a higher priority for them than promoting chastity, serious anti-abortion activists will promote open, honest conversations about sex within religious communities.

      Approximately 85% of Christian youth have sex before marriage and the rate of abortion is as high among Christian believers as non-Christians, so beyond-abortion advocates will work diligently to ensure that Christian young people are equipped to manage their fertility and thus initiate pregnancy only when they are prepared to carry forward a new life.Because beyond-abortion activists are single-mindedly intent on reducing abortion, they will take to heart the social science research showing that shaming—for example through abstinence-only sermons, books and classes—drives down intimate conversations and preparations for safer sex while doing little to delay or reduce more impulsive sexual activity. They will recognize that guilt and shame about normal sexual urges can lead to denial, wishful-thinking, church-avoidance and impulsive high-risk behaviors. They are also committed to helping young people understand and manage sexual desire and pleasure rather than simply trying to suppress those urges, which has been shown not to work. They will challenge old attitudes that treat youth contraception as “premeditated sin” or pregnancy as a punishment and will instead help young Christians to explore the spirit and purpose of ancient chastity laws. They will develop faith-compatible programs like Our Whole Lives, which was created by the Unitarian Church to integrate thoughtful, responsible family planning with other spiritual and moral wisdom.
    3. Serious beyond-abortion advocates will treat the school system as part of the sexual education “village.”

      To quote a research summary from Advocates for Youth: “Evaluations of comprehensive sex education programs show that these programs can help youth delay onset of sexual activity, reduce the frequency of sexual activity, reduce number of sexual partners, and increase condom and contraceptive use . . . teens who received comprehensive sex education were 50 percent less likely to experience pregnancy than those who received abstinence-only education.”Recognizing that some families struggle with addiction, mental illness and other challenges that keep kids from getting excellent health information and care and recognizing that some children suffer unwanted sexual contact at home, serious anti-abortion activists will support school efforts to fill knowledge gaps. They will invest in accountable, effective sexual health curricula demonstrated to delay sexual initiation and reduce risky sexual behavior (as measured by self-report, STIs, pregnancy and abortion). They will also lobby for age-appropriate education that starts long before youth become sexually active. When public dollars are limited, they will fund these materials and programs through charitable giving. Beyond-abortion advocates will insist that family planning be integrated into educational and career planning, not because this helps students attain their goals but because preventing surprise pregnancy prevents abortion.
    4. Serious beyond-abortion activists will recognize that attempts to restore traditional gender roles and the traditional family formation sequence (education-marriage-sex-childbearing) have largely failed. They will also recognize that abortion prevention must adapt to a shifting pattern of pair bonding and family formation. Expanding beyond abstinence-till-marriage, they will deploy whatever tools are necessary to reduce the pregnancies that lead to abortion.

      For over 20 years, advocates for child well-being promoted a return to traditional marriage as a means to ensure that parents get ready before getting pregnant. Lead advocate, Isobel Sawhill (National Campaign to Prevent Teen and Unplanned Pregnancy, Generation Unbound) concedes that the changes in family structure are likely irreversible and that new methods are needed to support well-timed pregnancy and family flourishing. To reduce abortions, serious anti-abortion activists will adopt a pragmatic approach to intentional childbearing and family well-being, including community services for young families and access to better birth control.
    5. Serious anti-abortion activists will drive a technology revolution in contraception—from every-day and every-time birth control methods to long-acting contraceptives like IUDs and implants that radically reduce unintended pregnancy and abortion.

      Long-acting contraceptives are the most dramatically-effective means to date of reducing demand for abortion. A St. Louis program that offered top-tier, long-acting contraceptives to 9,000 women and youth dropped unwanted pregnancy and abortion to less than half the local average. A Colorado program that provided long-acting contraceptives to sexually-active teens reduced teen pregnancy and abortion by 40 and 35 percent respectively. Serious anti-abortion activists will challenge the false perception that these methods work to end rather than prevent pregnancy and instead promote the science-based awareness that these methods are true contraceptives with bonus health benefits. They will work to reform liability practices that undermine development and distribution of better birth control.
    6. Serious anti-abortion activists will ensure that young and poor women in marginalized communities have access to excellent reproductive health services free of charge, since these are the youth and women with the highest rates of unplanned pregnancy.

      While unsought pregnancy and abortion are declining for middle and upper middle income families, they are on the increase among those least able to absorb the impact of another child. But making excellent contraception available to teens at no cost can drop the abortion rate by three quarters. As is, Title X family planning services prevent 2.2 million unplanned pregnancies yearly, without which the abortion rate would be two-thirds higher.Drawing on tested models like A Step Ahead in Memphis, serious anti-abortion activists will create programs that recognize the complexity and financial challenges of life in poor communities. These programs will provide rapid response, single-visit services and they will systematically eliminate financial barriers to better birth control. They will address anxiety (and contraceptive avoidance) that is due to forced sterilizations and other bad history and ensure that women are freely able to choose and switch contraceptive methods, as well as have them removed as desired.
    7. Serious anti-abortion activists will insist that medical practices be updated so that family planning becomes a routine part of adolescent medicine, family practice, prenatal care, and hospital labor and delivery services.

      Women and men are most likely to engage in effective pregnancy prevention when primary care providers and other doctors routinely assess family plans and fertility management as a part of all medical care. Serious anti-abortion activists will promote innovative and effective programs that treat pregnancy intentions like one more vital sign for both healthy and chronically-ill patients. They will ensure that continuing education programs teach doctors how (and why) to include family planning conversations in prenatal care and birthing services. They will monitor hospitals and other care systems to ensure that the best fertility management options are available on patient request.
    8. As both unintended pregnancy and abortion decline, serious anti-abortion activists will ensure that any woman who does end up with a surprise pregnancy will never be driven by financial or educational or career concerns to terminate that pregnancy.

      Forty percent of women seeking abortions cite financial concerns as a factor in their decision to end a pregnancy. Serious anti-abortion activists will tackle structural barriers to broad family prosperity including policies that create income inequality and cause families to fall out of the middle class. They champion family-friendly workplace norms and public policies including maternity leave, paid family leave, affordable childcare, and mom-friendly education alternatives for youth and women who decide to carry forward a surprise pregnancy.
    9. Serious abortion advocates will work to minimize maternal health problems and fetal anomalies by promoting pre-conception care and prenatal care and by ensuring that fertility management is integrated into care for chronic conditions such as diabetes and HIV.

      Only a small percent of abortion is triggered by threats to maternal health and life, or by fetal anomalies, but serious anti-abortion activists will work to prevent these difficult situations. They will raise awareness that preconception care can prevent some fetal anomalies and maternal health risks and they will make sure that medically-compromised women receive integrated care so that high-risk pregnancies occur only when a woman or couple actively wants a baby.
    10. With an eye to the future, serious anti-abortion activists will aggregate $200 million in philanthropic dollars, public research funds and investment capital to develop better birth control for men and take it to market.

      A man is involved in every pregnancy and men are involved in many abortion decisions, but today male contraceptives lag behind female contraceptives by almost a century. As of 2015, the best reversible method for women has an annual pregnancy rate of 1 in 2000, while the best for men (the condom) has a 1 in 6 annual pregnancy rate. Serious anti-abortion activists will recognize that giving men better means to manage their fertility will result in fewer surprise pregnancies and fewer abortions.

Forty years after Roe v. Wade, the Pro-life movement is a radical failure by the very metrics that abortion foes cite to inspire their base—or would be if the goal were actually to eliminate abortion. Unintended pregnancy and abortion are in decline, thanks to a number of cultural and economic factors and better birth control. But American care providers still serve over a million women seeking abortions annually and over 900,000 of these women terminate a pregnancy.

Self-described abortion foes in Congress pass copy-cat TRAP laws (targeted restrictions of abortion providers) that drive up the price of abortion care. Other self-proclaimed abortion foes have launched a multi-year “yuck factor” media campaign aimed at triggering moral and physical disgust. Still others harry women and care providers, forcing them to walk gauntlets of posters and prayers at clinic entrances or stalking and doxing them online. Indeed, self-proclaimed foes have so stigmatized abortion care that most of us have no idea which third of our female friends have terminated ill-conceived pregnancies.

But, if a half century of evidence from around the globe is to be believed, no amount of shaming or harassing women, nurses and doctors—however well-organized and sustained—will produce anything close to a 90 percent reduction in abortion. Nor will another 800 restrictive laws like those passed in the last twenty years, even if they criminalize women and providers. Such approaches may force some women to carry forward unwanted pregnancies, but their effect is limited by the power of human desperation. Extreme restrictions and stigma in Eastern Europe filled orphanages with unwanted babies but also filled backrooms with bleeding women. In pre-Roe America, compassionate clergy became weary of burying dead parishioners and helped to create an underground railroad to safe. Around the globe, 22 million women each year undergo a back-alley abortion rather than carry yet another unwanted pregnancy to term and over 20,000 pay with their lives. More restrictions, more disgust, more stigma—these may feel righteous to some, but at best they produce an impasse that destroys dreams and hopes and even lives and that satisfies no one.

By contrast, we know what it would take to make most abortion simply go away. Ironically, the upstream solution lies in the common ground between those who oppose abortion care and those who support it—the value we all place on empowering young people to flourish, and parents to love and care for their children. The only question is whether an anti-abortion movement will emerge that takes this challenge seriously.

Originally published at ValerieTarico.com

Who Aborts the Most Fertilized Eggs? Families Like the Duggars

blastocystA woman who values fertilized eggs or who believes her deity does should use the most highly effective contraceptive available.

Most fertilized eggs spontaneously abort during the first weeks of life. Estimates of death before implantation range as high as 80 percent and bottom out around 45. More than thirty percent of those that do implant later die on the vine. This means that unprotected sex produces more dead fertilized eggs than live babies. Reality TV’s Duggar parents are fundamentalist Christian opponents of contraception and abortion who have produced “19 Kids and Counting.” Based on the live births that Michelle Duggar delivered, we might estimate that Michelle and her man-on-a-mission flushed somewhere between 17 and 75 precious little bundles of joy in order to get the herd they have.

Any woman who leaves family planning to chance or her deity probably has a fertilized egg in her Diva Cup most months. Gross image, I know. But you know what’s really gross? The cup of righteous ignorance that fetus advocates are asking us to swallow when they claim that every hollow ball of human cells is sacred to whoever or whatever created the universe.

The Reproductive Funnel

The fact is that nature’s god designed reproduction as a big funnel. A lot more eggs and sperm get made than will ever hook up with each other. Many more eggs get fertilized than will ever implant. And more zygotes implant than will ever grow into babies. The world’s major religions, including the most extreme forms of Christianity, Islam and Judaism, tacitly acknowledge that these reproductive false starts are not people by declining to name or baptize the ones that women’s bodies expel on a regular basis.

If we are honest, even the most conservative Baptist or Bishop claims personhood status for the human embryo only when the decision making of women is at question. No religious sect, even Mother Teresa’s Missionaries of Charity, argues that we should save as many embryos as possible among the hundreds of thousands that die daily. No religious hierarchy dedicates its formidable financial resources or political clout to making this a global priority on par with, say, ending starvation.

In his now classic Discover article, “The Good Egg” science writer Stephen Hull lays out what is known about the process of conception, and he points out the difficulty that biology poses for those who want embryonic life legally protected:

The high failure rate begs challenging ethical questions. If life begins at conception, as many believe, why are so many lives immediately taken? If, as some ethicists argue, nascent life must be protected, how do we assess the degree of moral entitlement due a nascent entity that fails to pass nature’s own muster perhaps 80 percent of the time? And if the fate of an organism is indeed inscribed in the earliest biological inklings of an egg, does life begin with the gametes [the egg and sperm]?

Ethicist Toby Orb at Oxford says that if embryos have the same moral standing as persons, then spontaneous embryonic death should be the most horrendous moral problem of our time. He compares it to a plague that he calls The Scourge:

The Scourge struck swiftly and brutally. This terrifying new disease, more deadly than any before it, left no part of the world untouched. From the poorest countries in Africa to the richest countries in the West, it killed with equal, horrifying efficiency. It struck quickly, killing most of its victims within a few weeks of onset, and silently, for there were no detectable symptoms prior to death. Before the Scourge, the global death rate was 55 million per annum. That is, all causes of death—old age, war, murder, disease, and so on—conspired to take 55 million lives each year. The Scourge changed this dramatically. It alone killed more than 200 million people every year. . . . . Compared with the Scourge, all other problems seemed insignificant. . . . Other projects had to be put on hold and a major international effort directed toward loosening the Scourge’s grip upon humanity.

Religious groups that claim moral equivalence between embryos and persons and then fail to treat spontaneous embryo death as The Scourge are hypocritical, at best. That said, there is wisdom in their failure to walk the walk.

The Wisdom of Abortion

The processes that knit together the beginnings of life are incredibly effective in the long run, but at least at the start, they optimize for quantity over quality. Fertilized eggs and multi-celled blastulas and even more complex embryos wither for many reasons, not the least being that reproduction is hugely imperfect and a lot of egg-sperm mergers are defective. Alternately, they may flush out because the slow journey from fallopian tube to uterus got interrupted, or the mother’s womb wasn’t quite ready, or her immune system treated the embryo as a foreign invader; or for reasons yet unknown. Contraception researcher Dr. David Grimes describes the fascinating beginning stages of human life, how things go wrong, and how impressively nature eliminates most of the faulty embryos in his book, Every Third Woman.

Virtually all sexual reproduction, whether of plants or animals, follows a similar pattern, with lots of false starts built into the equation and a fertility rate that compensates. No farmer expects every seed to grow. Somewhat ironically, the Christian Bible reminds us of this in a story known as the Parable of the Sower:

A sower went out to sow. And as he sowed, some seeds fell on the path, and the birds came and ate them up. Other seeds fell on rocky ground, where they did not have much soil, and they sprang up quickly, since they had no depth of soil. But when the sun rose, they were scorched; and since they had no root, they withered away. Other seeds fell among thorns, and the thorns grew up and choked them. Other seeds fell on good soil and brought forth grain. (Matthew 13: 3-8 NRSV)

How Contraceptives Prevent Conception And Spontaneous Abortion

The fact that fertilized egg death is so common means that all birth control methods available today reduce the rate of embryonic hari-kari, and the more effective the contraceptive the more this is true. Top tier contraceptives, including the IUDs so hated by the Hobby Lobbyists, prevent more egg death daily than every pro-life picketer in America combined. And that’s not even counting how much therapeutic abortion decreases when women have access to better birth control.

Here is how they actually work:

  • The etonogestrel implant (Nexplanon) categorically shuts down ovulation. It has a published annual pregnancy rate around 1 in 2000 but in reality every pregnancy that occurred during clinical trials was conceived after the implant was removed. No egg, no fertilization, nothing to implant or abort. The fact that it also thins the uterine lining and thickens cervical mucus is largely irrelevant because women on the implant basically don’t ovulate.
  • The levonorgestrel IUD (Mirena, Skyla) thickens the mucus plug at the entrance to the uterus, so that sperm can’t get through. No access, no fertilization, nothing to implant or abort. Once settled into place, it has an annual pregnancy rate around 1 in 800. Secondarily, a hormonal IUD also thins the endometrium, which is why periods decrease by 90 percent over time—which, incidentally, has some serious health benefits. A sperm that managed to get through and fertilize an egg would meet an unprepared uterus, but preventing implantation is not the big way this IUD prevents pregnancy. We can be confident that fertilized egg death in this case is less common than it would be without the protection—or with less effective protection like the Pill, which in real world use, has a 1 in 11 pregnancy rate.
  • The nonhormonal copper IUD (Paragard; annual pregnancy rate 1 in 500) releases ions that act as a spermicide impairing a little egg-seeker’s ability to swim. They may alter the surface of the egg as well, preventing penetration. In other words, the primary and intended mechanisms of pregnancy prevention—despite all squawking to the contrary—are anti-conceptive aka contraceptive not abortifacient. IUDs may also heighten an immune response in the reproductive tract. Lastly, of the top tier birth control methods, the Copper IUD is least effective and most likely to end up with a situation where a fertilized egg might bump up against the IUD itself and then flush out. But this happens far less often than when a women is not contracepting or is using a less effective family planning method. That includes the Pill, the condom and especially—Are you listening Hobby Lobby?—the rhythm method or “let go and let God.”

So, for the record let me say it again. A woman who values fertilized eggs or who believes her deity does should use the best birth control available. She also might want to do a little reading on the biology of beginnings.

Originally published at AwayPoint