"Prevention First": Dumb Plan or Dumbest Plan?

by Susan E. Wills

May 5, 2006

Hoping to undo the perception that the Democratic Party stands for unlimited abortion, Party leadership is promoting a "Prevention First" bill as a "pro-life" blueprint to reduce unintended pregnancies and abortions. The bill's solution: Easier access to prescription contraceptives, including so-called "emergency contraception."

The strategy has intuitive appeal. If sexually active women use contraception, their risk of unintended pregnancy will be reduced, but definitely not eliminated.

What's wrong with this strategy? Setting aside for a moment the moral issues of sex outside marriage and contraceptive use, Prevention First presents two problems: 1) it has already been tried and failed; and 2) it results in significantly higher rates of sexually transmitted diseases (STDs).

Seriously, does anyone really think there's a need for more contraception out there? According to the Centers for Disease Control and Prevention (CDC), contraceptive use is "virtually universal among women of reproductive age." A recent Guttmacher Institute study, "Abortion in Women's Lives," reports that 89% of "at risk women" (sexually active women of reproductive age "at risk" of becoming pregnant) use contraception, and 98% have used it in their lifetime.

If, as claimed, contraception were so "easy to use and effective" in reducing unintended pregnancies and abortions, could somebody please explain why 48% of women with unintended pregnancies and 54% of women seeking abortions were using contraception the month they became pregnant? Oral contraceptives require "perfect use" to be "highly effective." Condoms must be used correctly and consistently, and they still break! Condoms carry a 15% risk of pregnancy with typical use over 12 months, compared to oral contraceptives, which have a 9% risk with typical use over 12 months.

Even Guttmacher's recent "Contraception Counts" report, cited by Prevention Firsters, shows no correlation between better access to contraception and lower abortion rates. California and New York rank among the top 5 states for contraceptive access, and among the top five in having the highest abortion rates. States ranked among the five "worst" for contraceptive access – Kansas, Utah, and North and South Dakota – have the four lowest abortion rates in the country. States in between are all over the board.

Professor David Paton of Nottingham University has conducted four major studies since 2002 on this issue. He consistently found that increased availability of contraception, including emergency contraception, cannot be shown to reduce pregnancy and abortion rates. Although easier access may reduce the risk of pregnancy among some teens who are already sexually active, easier access encourages other teens to become sexually active, or become more so and with multiple partners. Between 1999 and 2001, with improved access to family planning clinics in the United Kingdom, teen visits rose over 23% -- and the number of sexually active teens rose almost 20%, while STD rates rose 15.8%.

I have a plan that will reduce unintended pregnancy, abortion and new STD rates to zero: abstinence before marriage, fidelity within marriage, and respect for the gift of your fertility. Oh, wait. The Catholic Church already thought of that plan. Try it anyway. It works every time.