Wednesday, April 15, 2009

Contraception and Abortion

In my FindLaw column today, I discuss a recent speech by a spokesperson for Feminists For Life (FFL), in which she said that FFL does not take a position on contraception (because some members favor it and some oppose). I criticize FFL's failure to take a position and argue that especially for an organization that is categorically opposed to all abortions yet prioritizes feminism, it is critical to support women's access to contraception.

In this post, I would like to explore an argument that some people have made about one form of contraception: birth-control pills. The argument has several components. First, birth-control pills have side effects that its makers did not initially fully appreciate and thereby gave women the illusion that they could "harmlessly" avoid the risk of pregnancy. Second, birth-control pills provide protection against one risk of sex (pregnancy) without doing anything to protect against sexually transmitted diseases (STD's). As a result, some have suggested, various S.T.D.'s have proliferated to a point at which virtually everyone above a certain age is a carrier. And third, birth-control pills suppress women's natural hormonal cycles, which has the consequence of obscuring an important physiological basis for selecting a mate: pheromones (which, among other things, attract women to men with whom they are unlikely to be close genetic relations).

These arguments, to my mind, are important in illustrating unanticipated effects of medicine. While we "treat" one risk or illness, we must remain mindful of the possibility that we thereby create more problems than we solve. This phenomenon, however, is hardly unique to birth-control pills. Indeed, another hormone treatment -- hormone replacement therapy, offered to relieve symptoms of menopause and assist in fortifying menopausal women's bone density -- has proved to pose enough health risks to motivate many doctors to recommend strongly against HRT. Other drugs (including, to continue on the theme of women, thalidomide) have turned out to be devastating in their unanticipated impact.

The introduction of any new drug is an experiment, and it is impossible to know in advance that costs will not ultimately outweigh benefits. To be sure, one might believe that, unlike various other medications, birth control pills confer no benefits worth having. That belief, in turn, rests on the view that there is not a good reason to try to separate sex from procreation, a view that is part of religious dogma but that is not otherwise especially appealing (as I argue more directly in my column).

Furthermore, even if we conclude, in retrospect, that the birth-control pill was, on net, a negative development, (a far-from-uncontroversial proposition), this does not have any necessary implications for other forms of contraception. Condoms, for example, do protect against sexually transmitted diseases (as well as pregnancy), do not appear to have untoward medical side effects, and leave a woman's hormonal cycles alone. The same might be true for other methods, still under development. And finally, for a couple that is truly monogamous but does not want children, various contraception methods that might not suit relative strangers (such as diaphragms, intra-uterine devices, and sponges) become far more attractive. And it bears emphasizing -- for those who favor abstinence -- that even married couples having exclusive sexual relations within their marriage might want, on occasion, to avoid having more children. It seems neither feminist nor particularly wise for a group that opposes abortion to have nothing to offer such people.

Posted by Sherry Colb


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