An Argument I Wish Liberals Would Not Make So Much
As the debate over contraception coverage continues, there is an argument that supporters of such coverage frequently rely on, that I believe should not be the centerpiece of the pro-coverage case. At best, it should be offered as a side dish. The argument is that some women need birth control pills for reasons other than preventing pregnancy.
Look, I know that a lot of women, even virgins, take hormonal birth control for certain gynecological problems, to control cramps, etc. Still, the primary purpose of such medication is to prevent pregnancy, and the majority of women who take such pills, take it for this reason alone. To rely on the off-label use as a justification for mandating coverage implicitly concedes the wingnut argument that sexually active women, even married women, should just “hold an aspirin between their knees” if they don’t want to get pregnant. It also concedes their argument that sex for pleasure, as opposed to procreation, is a morally reprehensible “lifestyle” choice that should not be countenanced by making birth control more cheaply available.
I strongly disagree with such a stance, for reasons stated below:
1. Preventing pregnancy is a legitimate medical decision. Pregnancy is potentially life-threatening, and certainly far more life-threatening than non-pregnancy. Even when it does not kill, it frequently involves the onset of serious chronic conditions, organ failure, stroke, hospitalization and major surgery. Contrary to the argument often made by conservatives — and most often by male conservatives who never deign to learn a single fact about female reproduction — pregnancy and childbirth severely wear out a woman’s body. Thus, taking hormonal birth control is a medically justified form of basic preventive care.
2. Indefinitely using abstinence as a form of contraception is both unrealistic and unhealthy. This is especially true of marriages. Telling couples they must abstain for as long as they don’t want to have children — or act as breeders for more “deserving” couples every time they perform the most basic marital act — represents unnecessary and severe privation. Prolonged abstention from sex degrades a marital relationship, creates tension, and ultimately leads to a breakdown of the family. Advocating such a lifestyle is ironic indeed coming from people who claim to be all about “family values”.
3. Hormonal birth control is an invaluable tool for preventing pregnancy secondary to rape. The rates of rape have declined over the past thirty years or so, but they are still high enough that rape is a very real possibility for any woman. At the same time, conservative state legislatures are imposing increasingly onerous burdens on pregnant rape victims seeking to abort, up to and including subjecting them to abusive “counseling” and invasive trans-vaginal ultrasound procedures. I doubt very much your average rapist will be gentleman enough to put on a condom with spermicide. (Especially if he is a conservative. Doubly so if he is a Rush Limbaugh fan.) In this day and age, when conservatives are redoubling their efforts to force victims of rape to bear their rapists’ children, taking this basic precaution against being raped twice has never been more important.
Of course, the fact that hormonal birth control is used as treatment for medical problems is also important and should be mentioned. And, the fact that certain religious institutions want to be able to deny contraception to their employees even at the cost of such employees’ lives is particularly disturbing. Still, we should not lose sight of the fact that even in the absence of acute medical problems, contraception is part of basic preventive care.
Incidentally, refusal by insurance carriers to cover preventive care has never made sense to me, from a purely business standpoint. In any aspect of medicine that I can think of, preventive care is always cheaper than the treatment of conditions that result from a lack of prevention. If the cost of contraception at $3,000 per year seems high, consider that pregnancy and childbirth can easily cost around $10,000, and that’s assuming there are no problems requiring surgery, prolonged hospitalization, or treatment of pregnancy- and labor-related complications. Of course, it makes more sense when you realize that conservatives don’t want obstetrical care to be covered by insurance, either. After all, prenatal care and a safe, comfortable hospital birth with pain relief and the safeguards of modern medicine all mean the bitch got away with having sex — right?