Prevention, Please!

October 17, 2011

Unplanned Pregnancy


Last week, by a vote of 251-172, the House passed H.R. 358 (PDF). While the vote was largely along partisan lines, I should point out that both Reps. Biggert and Hanna, Republicans, voted against it, and plenty of Democrats voted for it. The bill, formally called "The Protect Life Act" (and by pro-choice groups, "The Let Women Die Act"), has been called "extreme legislation" by Third Way (PDF), a think tank that creates and advances moderate policy and political ideas. "Masquerading as an attempt to ensure that federal funds do not go to pay for abortion services, this legislation is actually an effort to radically change settled law on abortion on multiple fronts. The provisions in the bill extend far beyond what was even discussed during last year's debate over abortion in health care reform."

I'm not writing to debate abortion. Clearly, for many in Congress, this is a time honored tradition. I also feel the need to state clearly that I respect both the pro-choice and pro-life points of view. However, I do want to make a simple point that I hope we can all agree on--if you want to reduce abortion, there IS a silver bullet and it's called contraception. As my colleague Andrea Kane noted in her post on October 7th, the House also recently released a Fiscal Year 2012 spending bill (PDF) that would eliminate the Title X program (PDF), which provides free or low-cost birth control to women in need. Furthermore, the spending bill would block implementation of The Affordable Care Act (health reform) thus also rolling back Medicaid family planning services (PDF) in several states, rescinding mandatory funding for evidence-based teen pregnancy prevention, and ending the new provision that will allow many women to get contraception without co-pays.

To me this seems at odds with an anti-abortion stance. Half of all pregnancies in the U.S. are unplanned, and about half of those end in abortion. Without much difficulty, it stands to reason that if we reduce unplanned pregnancy, we'll reduce abortion. What reduces unplanned pregnancy? Contraception! So, what's the problem then? Why, if contraception in various forms has been out there for years, do we have such high rates of unplanned pregnancy? (They're higher than our developed-country trading competitors by the way). Well, first, contraception is not always affordable. This is what programs like Title X and Medicaid seek to address, and what The Affordable Care Act women's preventive services provision was meant for--to make contraception more affordable. With cost barriers removed, women (and men) can choose the contraceptive methods that are right for them. Instead of picking what might just be cheapest, they can for example, go to and check out all the methods out there, hear real people talk about each method, and learn where and how to get it. By reducing cost and increasing knowledge, we can hopefully make a huge dent in unplanned pregnancy, and consequently abortion, in this country.

Surely this is better than fighting it out over abortion? Can't we agree to disagree on abortion and focus on preventing unplanned pregnancies in the first place? In a forthcoming poll from The National Campaign, the question was asked: "How much do you agree or disagree with the following statement: Policymakers who are opposed to abortion should be strong supporters of birth control." Eighty-five percent of respondents agreed with the statement, with 62 percent strongly agreeing. Some have argued that these votes on abortion are not what Congress should be focusing on. I agree, not simply because we have a jobs crisis in this country, but also because we have a solution to a problem--contraception--and that's where our focus and funding should be.

Authored by: Rachel Fey

Rachel Fey is the Director of Public Policy at The National Campaign where she is responsible for the organization’s health policy work, including implementation of the Affordable Care Act, Medicaid family planning, and the Title X Family Planning Program. She also focuses on health disparities and budget and appropriations, specifically funding for teen pregnancy prevention programs and public funding for family planning.

Prior to joining The National Campaign, Ms. Fey was Manager of Government Relations at the National Family Planning and Reproductive Health Association (NFPRHA) where she worked on key provisions of the Affordable Care Act and the Medicaid and Title X Family Planning programs. Recognized in 2013 by the Professional Women in Advocacy Conference as an Up and Coming Practitioner, Ms. Fey has over a decade’s experience working in the field of non-profit reproductive health, including for the Association of Reproductive Health Professionals (ARHP) and the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs.

Ms. Fey holds a BA in International Studies from the Johns Hopkins University.  She lives in Washington, DC and stamps her passport as often as possible.

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