Wednesday, October 31, 2012

Condic on the Difference Between Embryonic Humans and Hydatidiform Moles [Jay Watts]

One of the more advanced questions that we encounter on campuses and in discussions with more sophisticated abortion rights advocates goes as follows:

The biological products of sexual reproduction are not always human beings. Hydatidiform moles (HM) are the products of sexual reproduction, but in this case an enucleated egg is fertilized and only the genetic material of the father is present. In the early stages of growth HM will look like a developing human life. It will cleave and grow and if you were looking at it you would see something seemingly indistinguishable from a human being. Therefore – the arguer says – not all embryos are human beings and it is wrong to say that the product of human sexual reproduction is a human being from fertilization.

Maureen Condic addresses this and similar arguments in her contribution to the incredible resource Persons, Moral Worth, and Embryos: A Critical Analysis of Pro-Choice Arguments. Her article entitled A Biological Definition of the Human Embryo offers an analogy to help clear up what is wrong with this argument that I will tweak just a little from CD's to ipods. She talks about the similarities between the songs “Twinkle Twinkle Little Star”, “The Alphabet Song”, and “BaBa Black Sheep”. All three begin with the exact same first measure. Hum the first few notes of each song and you will see that if someone were playing the music from any of those songs it would be impossible distinguish which song was being played in the first measure simply by hearing it. Does that mean that the song playing on my daughter's ipod shuffle is potentially any one of them? Is it potentially “The Alphabet Song” and only literally becomes “The Alphabet Song” when you get to the fourth measure and you can now be certain that it was neither “BaBa Black Sheep” which diverges in the second measure nor “Twinkle Twinkle Little Star” which diverges in the fourth measure? Of course not. The song playing on her shuffle was always one or the other you just couldn't know for certain by listening till it reached a certain point in the development of the song. At any point that I plugged the shuffle into the Macbook it would identify the actual song on the playlist and would not say “Can't Know Just Yet”.

In the same way Condic says:

There are several reasons why it is both misleading and inaccurate to define what is and what is not an embryo based on later developmental events (implantation, formation of the primitive streak, brain function, etc.). First, development results in the maturation of an existing organism; it does not transform an entity from one kind of thing into another kind of thing. Just as a CD playing “The alphabet song” is not transformed from a “pre-alphabet song” state at the fourth measure, but rather plays this song from the beginning, embryos are not transformed into human beings once some developmental event occurs.

Elsewhere she also offers the following:

Despite an initial (superficial) similarity to embryos, hydatidiform moles do not start out as embryos and later transform into tumors, they are intrinsically tumors from their initiation. Moreover, they are not frustrated embryos that are “trying” (yet unable) to develop normally. Just as a CD recording of “Twinkle, twinkle little star” is not somehow thwarted in its attempt to play the “Alphabet song” by a deficiency of notes in the fourth measure ..., hydatidiform moles are not “blocked” from proceeding along an embryonic path of development by a lack of maternally-imprinted DNA. Rather, hydatidiform moles are manifesting their own inherent properties—the properties of a tumor. Even in the optimal environment for embryonic development (the uterus), hydatidiform moles produce disordered growths, indicating they are not limited by environment, but rather by their own intrinsic nature; a nature that does not rise to the level of an organism... If the necessary structures (molecules, genes etc.) required for development (i.e., an organismal level of organization) do not exist in an entity from the beginning, the entity is intrinsically incapable of being an organism and is therefore not a human being. Such entities are undergoing a cellular process that is fundamentally different from human development and are not human embryos. [emphasis hers]

For all of you that are not musically inclined I offer this final analogy. My wife and I used to travel out to the western states every year prior to having children to hike. I apparently possess a natural ability to spot wildlife that was impressive enough that a job was offered on the spot by a group that leads tourists on hiking and wildlife spotting tours through the Jackson Hole area. (Not a day goes by that I don't fantasize about what my life would have been like had I taken that job, but that is a different story)

The key to my success was having a good teacher the first time I went out on a wildlife spotting expedition in the Tetons. He told me that you don't look for a moose, bighorn, or elk with spotting scopes or binoculars. You look for big rocks with your naked eye. Then if you patiently wait and watch the rocks sooner or later one of the rocks will start to move. They all look like rocks at first but eventually the living things distinguish themselves from the non-living things around them. Then you use your spotting scope to figure out specifically what animal you are seeing.

In the same way, embryonic humans and hydatidiform moles look alike in early growth stages. If we watch them for a little while they will distinguish themselves for us. What we learn is not that the embryo failed to develop and turned into an HM, but that what looked like a human embryo was always something else. The human being existed from the beginning of its organized development and the fact that other things mirror the early developmental events of that human life does not effect the identity of that nascent human life. It just means that from certain vantage points we only truly understand the nature of a life as we observe its developmental arc. The HM is destined to break down into an aggressive growth while the human being will progress to the blastocyst stage and continue on through the dynamic self directed organized process of human development.

Tuesday, October 30, 2012

More Thoughts on the Bodily Rights Argument for Abortion [Serge]

A few years ago I wrote this article in the Christian Research Journal regarding the the bodily rights argument for abortion rights.  After discussing this issue with a friend, who is seeing this argument being used more frequently on campus, I wanted to give some more thoughts about the issue.

In short, the bodily rights argument states that even if a human fetus is a full fledged member of the human family, a mother has the right to kill her offspring due to the fact that she has control over her own body.  Please see the article for a more detailed explanation, but one of the more popular ways to illustrate this argument is by mentioning that the state does have the right to make a mother donate an organ or donate blood to her children even if not doing so would result in their death.  It would be considered a moral good if she choose to do these things, but the state cannot compel her by force of law to use her body in this way even if her child dies as a result.  Likewise, a mother cannot be compelled to continue a pregnancy, which also uses her body, even if discontinuing a pregnancy results in the death of her child.  Thus abortion should remain legal.

Before I get into answering this argument, one thing needs to be emphasized.  The strength of this argument from the pro abortion rights side is that is would allow abortion to remain legal regardless of the moral status of the human fetus.  For that reason, before we continue, the abortion rights advocate needs to acknowledge at least for the sake of argument that the fetus in question is a human individual with human rights.  So-called "personhood" arguments cannot be brought in at any point if they are arguing from bodily rights.

Now we've established that fetus has full moral status,and is in fact a child of the mother in question, let's move on to the issue of parental provisions, or things that parents provide for their children.  Many, if not most parental provisions are good, but not legally required.  For example, yesterday I drove my kids to soccer and violin lessons.  Few would argue that these provisions that I provided for my children were not a moral good, but are certainly not a legal obligation.  I can cease to give consent to these provisions at any time (and if there are a few more 40 degree rainy soccer games that might actually occur).  I would argue that most of the provisions that my wife and I provide for our children fall into this category.

There is another category of provisions that the state requires us to provide. These are admittedly more rare, but are quite important.  I am legally required to feed my child.  I am legally required to provide my children a safe environment.  If the authorities come to my house to find that my children have died because I did not feed them, or died because I did not them back into my house after they were playing I would not merely be considered a moral failure - I would be criminally prosecuted.  This seems very clear.

We could make a list of parental provisions that are optional and ones that are legally obligatory.  We would also include on the list of optional parental provisions the notion of providing an organ or a blood transfusion to a sick child.  This would be a parental good but we do not legally compel mothers to provide this to their children, even if the child dies as a result. 

Two question need to be answered here.  First why, why are blood transfusions and organ donation optional?  Second, and the big question is whether pregnancy is more consistent with the set of obligatory provisions or with the optional ones. 

I do agree that the state has no right to demand blood transfusions or organ donation from parents.  The reason, however, is very important.  The state should not obligate these parental provisions because the child is in a state of illness, and no one has the right to demand the use of another person's body to cure their disease state.   That, unfortunately, is the nature of disease.  If a young child dies of leukemia even though his mother could have donated her bone marrow to treat him, he doesn't die because of a lack of maternal bone marrow.  He dies because of his leukemia.  Although as a culture we do everything we can do mitigate the effects of disease, we still acknowledge that no one has the "right" to their health.  Thus the mother is not legally obligated to provide her organs or blood.

Compare this to the set of legally obligatory provisions.  In the case of feeding and providing safety for their child, we do legally compel parents to provide what is needed for the continued good health of their child.  If the child is otherwise healthy, the parents have an obligation to do a minimum to not cause a child to become sick or die.  Thus they are required to provide food and a safe environment for their child.

So what about pregnancy?  Is it closer to the set of obligations that are good but optional or closer to the obligatory provisions of providing food and safety for a child?  Another way to ask the question is to ask is the state of pregnancy one of health or one of disease?  If a pregnancy is considered a state of health for the child and mother, it seems the provision of pregnancy would be obligatory.  "Continuing a pregnancy" would be amenable to continuing to provide what is otherwise necessary (nutrients, oxygen, a safe environment) to support the child's good health.  If pregnancy is a disease state for mother and/or child, then the child has no right to demand the continued use of the mother's body, and withdrawing such support through abortion would be legally permissible and consistent with other optional parental provisions.

Clearly, the status of the vast majority of pregnancies is one of complete health for mother and child.  In fact, the consequences of considering pregnancy a pathological state would be widespread and disastrous.  For example, I have two pregnant women working for me at this very time.  Should I be allowed to send them home because they are "sick", and return only when they are "better"?  For this reason, the bodily autonomy argument fails to convince us that the parental provision of providing what a pregnant mother provides to her child is merely optional.  Just like a parent has a moral and legal obligation to feed their child, a pregnant mother has a legal and moral obligation to support the good health of her child during pregnancy.

There are a few objections to this line of reasoning that I plan on addressing in future posts.  These include:

1. Since pregnancies are not without risk, and some argue that continuing a pregnancy is safer than abortion, then a mothers provision is not legally obligatory because of the risk.

2.  The fact that the child is dependent and connected to the mother is more important than the obligatory provision that the mother provides food and nutrition during pregnancy.

3.  A mother can choose not to provide the obligatory provisions if she doesn't wish to by ways of adoption.  Since she cannot place a fetus up for adoption, by means of the child's dependency, she should be allowed to discontinue the pregnancy via abortion.

Thursday, October 25, 2012

We All Have Tough Questions [Jay Watts]

At every campus or group I have ever spoken to I offer the opportunity to ask questions after – or sometimes even during – my presentation. Without fail among the first questions asked is the question of how can pro-lifers defend restricting abortion in the case of rape. (Some people include incest, but incest is almost always understood as rape by a relative) This particular post is not about defending that pro-life position. Here are links to some posts that address that issue in various ways:

The point of this post is that I think we ought to be asked the tough questions, and LTI speakers welcome the opportunity to engage audiences on these issues. I admit I prefer face to face conversation to wrestling with anonymous trolls on-line who often argue dishonestly, but that is because however emotionally charged the issue is there is a cordiality and respect that can be cultivated in a genuine dialogue that is too easily lost on-line. That is not a condemnation of others as much as a recognition that we all seem to be testier and more defensive on-line and there is less productive discussion.

As such, I would love for abortion advocates to regularly face their own tough questions as has been recently pointed out by Trevin Wax here and at Patheos by mollie here.

If you support the current abortion on demand laws in the United States which recognize no limitations on the freedom of women to procure abortions that are grounded in the value of the unborn life (as opposed to PBA ban that outlaws a specific procedure but not the practice of late term abortions) do you also support the rights of women to abort their unborn children because the child happens to be female?

Stipulating that sexual orientation is genetic, if we developed a screening that could demonstrate with some degree of accuracy the sexual orientation of an unborn child would you support the rights of women to abort a child based on that sexual orientation either way? Should straight parents be allowed to abort their homosexual children if we can determine that it is genetic and verify that presence of that marker prior to birth?

Do you think that it should continue to be legal to abort unborn children with Down syndrome? Even at the estimated 80 – 90% rate currently seen? Even though we have the capability to minimize many of the physical problems that used to be associated with DS through various therapeutic measures and people living with DS can enjoy happy productive lives? Should a condition that does not diminish their quality of life make them legitimate targets for eugenic abortions because it is presumed they frustrate the plans of others?

If yes to all, are there any restrictions that you would place on abortions based on the preferences of the parents as to what type of child they would like to have? Should parents be allowed to abort children that have merely a genetic possibility but not certainty of illness? If so, should they be allowed to choose to abort based on the lack of desired traits?

A woman once came into the pregnancy center where I worked that wanted an abortion to end her morning sickness. Is this a justifiable reason to abort your child? Under our current law it is. Do you support laws that are so liberal as to allow abortion to relieve morning sickness?

Considering that most people are unaware of the permissive nature of our abortion laws in the United States, it would be instructive to all if all of us had to answer tough questions about our positions. I understand why women that have suffered the evil and devastating trauma of rape would want to hear an explanation from pro-life advocates as to why we think the law should compel them to carry their children conceived in rape to term. They deserve an answer. Similarly, the rest of us deserve an answer as to whether there are any reasonable limits to abortion rights. Does the abortion rights advocate protect the sexist destruction of unborn girls, the eugenic elimination of those with Down syndrome, and the ever growing practice of parents looking to dictate to the next generation whether they are allowed to live based on their ability to satisfy the ends and desires of the parents? Does championing a right to bodily autonomy of women mean that the abortion rights advocate believes we have no right as a society to protect innocent life from even the most superficial or callous justifications for abortion?

We all have our tough questions to answer. It is about time people started asking both sides.

Tuesday, October 23, 2012

Agnosticism About Life and Value [Jay Watts]

I have spent a lot of time recently studying and talking about agnosticism. Agnosticism in this post is simply the position that the proper response to a state of affairs or a body of evidence is to say that you cannot know the truth with any certainty. There are other things that people mean when they say “We can't know X” from objecting to the idea that we can know anything with certainty at all (except our certainty of that particular statement of knowledge) to objecting to the idea there are any objective truths to know at all (except the objectively true fact that there are no objective truths).

This particular form of agnosticism is a response to multiple opinions on a subject of some importance. I suppose we can be agnostic about unimportant things as well, but that form of agnosticism is more disinterest. For example, when a disturbing number of women and girls were consumed as to whether the heroine of the fictional Twilight series of books should choose her vampire boyfriend or her werewolf boyfriend I honestly had no opinion on the matter. Sure I didn't know, but more importantly I didn't care to learn enough to form an opinion. The agnosticism we are talking about is not just disinterested laziness. Intelligent and reasonable people see a large number of people with varying positions on a certain point and determine that given all that disagreement or given the large number of possibilities then the only answer that escapes arrogance or does not overreach is to humbly say, “I don't know given the evidence at hand.”

We see this when people argue that we simply can't know when life begins or when humans become valuable. They aren't saying that embryonic or fetal human life isn't intrinsically valuable like Peter Singer argues. They also are not saying human life absolutely does not begin at fertilization. They are arguing that there are too many variables to be able to know which position is true. In the face of such a state of affairs the only reasonable position is to say, “I don't know.” Then comes the next part of their reasoning, they conclude from this that we ought support liberal abortion laws given this inability to know. Wait... what?

Let's sort through a few problems here:

  1. As Alvin Plantinga points out in Warranted Christian Belief, any attempt to skirt the charge of arrogance by pleading agnosticism fails. Saying that given the evidence there is only one correct position is still claiming the superiority of a position. You are still saying that you are right and that holding any other conclusion is a mistake. If the people that argue that value begins at fertiliaztion with the presence of a new life or that say - like David Boonin - that value begins at organized cortical brain activity can be considered arrogant for arguing specific positions than so can the agnostic for arguing the specific position of intellectual agnosticism.

  2. We don't stop trying to determine the truth simply because a truth is difficult to determine. Plantinga says philosophy is just thinking really hard about something. Richard Feynman says the essence of science is patience in that if you looked, and you watched, and you paid attention, you got a great reward. If these two brilliant men are right then we know that science and philosophy – the two disciplines we use to argue the pro-life position - begin with subjects that require patience and hard thinking. As Hadley Arkes says, the absence of a consensus does not indicate the absence of truth. It may be that we need to be patient in our reasoning and invest some energy into our careful considerations to eliminate insufficient options and hone in on the best answer. That is usually the answer that best fits what we already know.

  3. As Frank Beckwith points out in Defending Life, when someone like Boonin argues that it is unclear at what point in the fertilization process it is accurate to say we have a new life and as a result the argument that life begins at fertilization is undermined they commit the fallacy of the beard. He writes, “just because I cannot tell you when stubble ends and a beard begins does not mean that I cannot distinguish bearded faces from clean-shaven ones.” He goes on to point out that any developmental marker that abortion rights advocates choose to bestow value is equally as fuzzy in its attainment whether it is something like determining when a child has self awareness or organized cortical brain activity. Yet they don't argue that because their own criteria arrive in an undetermined moment of development that it undermines their own position. At the end of fertilization we have a member of the human family and we argue that the members of that family are valuable by virtue of what they are not what they can do.

  4. Similarly, when some people claim that all life is one big indistinguishable process and so it is hard to say what a new life is they make the same mistake. We certainly do not seem to struggle between determining the mother from the unborn child in the process of aborting the child. When was the last time we heard an abortionist claim that due to the complexity of life and the indistinguishable nature of the whole life process in totality he accidentally killed the mother? It was just so hard to grasp what individual life was during the abortion procedure.

    My wife used to watch a show called Everwood. On one episode that dealt with abortion the pro-choice surgeon that the show centered on refused to perform an abortion. He had recently lost his wife and after the trauma of that loss the character began to understand something that I thought was profoundly stated in the midst of a deeply morally flawed episode. He said, “I may not know when life begins, but I sure know when it ends.” You hear the same sentiments in the writings of pro-life surgeons that were fighting abortion in post Civil War United States. They had seen so much death on the battlefield that they could no longer stomach the idea of people using medical knowledge to end innocent human life.

    Medical science has equipped doctors to identify embryonic human life and fetal human life with enough precision to successfully terminate that life to benefit either research or to end pregnancy. Therefore, we must accept that however fuzzy some biological processes seem we know what an individual zygote, embryo, and fetus are scientifically. They are whole, distinct, human life. We demonstrate our intimate knowledge of their individuality every time we target them for destruction.

  5. Finally, the idea that we can't know the identity or value of nascent human life cannot possibly lead to the conclusion that it is morally permissible to destroy that life without justification. I understand that the basis for this is the reasoning that if we don't know what the unborn are - whether in value or in biological identity - then we cannot impose on women that they must continue undesired pregnancies or limit the ability of science to pursue therapeutic cures for serious and debilitating illnesses. But even if we stipulate the case for agnosticism for sake of argument, the comparative costs paid by the different lives in question is such that it would seem the proper response is restraint not permissiveness.

    As Ronald Reagan once argued, if you are a hunter in the woods and you suddenly see and hear a rustling in the bushes it would be irresponsible and dangerous to start firing into the bushes. You have a duty to determine what it is in the bushes before you kill it. Greg Koukl's “Can I kill this?” analogy points that out as well. The central question comes back to “What is the unborn?” As many others have said including Beckwith and Arkes, only the most cynical understanding of neutrality imaginable would say the current abortion on demand laws in the United States – laws that permit abortion through all nine months for any reason when the ridiculously broad Doe v Bolton health exception is applied – do not favor one side over another. If the argument is that it is impossible to know which view is correct, then the neutral legal response can't be to say that we will then craft all the laws to reflect the views that they are not humans and do not matter. This is not agnosticism but radical abortion advocacy masquerading as something more reasonable.

Thursday, October 18, 2012

LTI Q & A: How Do We Punish Illegal Abortions? [Jay Watts]

LTI recently received the following question via e-mail.  I decided to share my quick response to the question on the blog:

Question: I appreciate the work that you all are doing in raising awareness about Pro-Life Issues.  As someone who is anti-abortion, I am not in favor of people taking the lives of their unborn children because they're inconvenient.  My problem is on the legal side- I am not comfortable with the idea of sending young girls to prison for abortions either.  America is one of the leaders in prison population already, there's excessive prison overcrowding, and I can't say that filling jail cells with teenagers or unwed women is the best solution either.  What do you all propose should be done legally if people broke a law banning abortion?

Answer: In the interest of time I won't dwell on some of your phrasings that I am a little uncomfortable with in how you describe the pro-life position and will directly address the question.

We must separate the two ideas.  In presenting an argument that the unborn are full members of the human family we are making a moral argument about their nature.  What are the unborn?  Moral arguments instruct us as to what is permissible in our interactions and what natural/pre-legal obligations we have to one another (if any).  Arguing the science, philosophy, and basic ethical questions does not require any defender of the pro-life position to have a legislative plan in waiting to apply whatever ethical conclusions are reached.

Should people become convinced of the truth of the pro-life position then it is fair to begin asking the question, "What next?"  If Roe/Doe/Casey are repealed it is not likely that you will immediately see an Amendment to ban abortion.  You would return to the pre-Roe/Doe environment where laws varied from state to state.  Questions posed to pro-life defenders about the nature of draconian laws that we would see put into place or that wonder how we would punish the crime of illegal abortion can be answered by a survey of the various abortion laws of the past.  It is not an ancient past to which we are disconnected.  There is ample legal precedent and discussion to guide our next step.

One thing that is traditionally consistent in abortion laws is that they tend to be lenient on women in regards to punishment.  There are multiple reasons for this.  The first is that in order to determine that an unjustified killing has taken place for the purposes of prosecuting at the level of murder you must legally demonstrate beyond a reasonable doubt that (1) the unborn human was alive, (2) that the mother deliberately participated in an action intended to end that life, and (3) that the life ended by virtue of that action.  You can imagine how difficult that would be to accomplish. Given that difficulty it was virtually unheard of to prosecute abortion in the same manner that murder was prosecuted.

Second, the emotional condition of the women was often taken into consideration.  As much as this seems to annoy some feminists, it is not unusual for emotional considerations to enter into the sentencing deliberations in criminal law.  Third, a jury of their peers is not likely to relish the opportunity of sending women to prison for reasons associated with both the first and second issues along with others.  Fourth, the prosecution was much more interested in punishing the doctors performing illegal abortions than the women, so they fostered a legal relationship that encouraged women to trust them (the prosecutors) rather than fear them. 

Considerations like these contributed to less severe punishments routinely being sought by prosecutors against women in pre-Roe/Doe America.  It is not hard to imagine that any legislators attempting to craft new restrictive laws would proceed by examining these types of reasonings.  

Finally, if the moral argument for the full humanity of the unborn is true then we already have a great injustice taking place.  There is no doubt that proceeding to apply this understanding of nascent human life to our legal system will be challenging.  I don't think that we should decide not to punish people for violation of important moral obligations because our prisons are full, though.  Even accepting that premise without argument for the sake of our discussion, it would be colossally bad reasoning to say, "We believe that action X is the unjustified killing of human life(abortion, mercy killing, vehicular homicide, etc.), but we are already prosecuting too many other things so we need to allow it without punishment."  That can't be what follows.  

If it is true, then we need to address that moral question on its own merits and not in conjunction with other moral issues.  Prison reform needs to be addressed directly (and is by organizations like Prison Fellowship Ministries) and any decisions about how to deal with that reform must be rooted in moral reasoning specific to the problem.  We can't simply say that women can't be punished for abortion because prisons need reform.  That approach does justice to neither question.

That is all the time I have.  If you want to read in depth discussions of abortion laws I would recommend both Joseph Dellepenna's Dispelling the Myths of Abortion History and Marvin Olaskey's Abortion Rites.  Thank you for your question.

Tuesday, October 16, 2012

What the Contraceptive Choice Study Really Shows [Serge]

Update: Lydia McGrew has a more extensive and detailed analysis of this paper over at What's Wrong with the World.

News reports for the last couple weeks have been glowing about a new study that purports to lower abortion rates by offering contraception for free.  "Free contraception cuts abortion rates dramatically" is an example from NBC news.  This sounds promising, but as usual a closer look at this study tells a very different story.

The study itself is part of the Contraceptive Choice Project in St. Louis.  The preliminary results of the study can be found here, and a pdf presentation from the study's main author can be found here.  The claim is that this study has shown that increasing access to contraceptives by making them free shows a general decrease in the unplanned pregnancy and the abortion rates.   There are a number of reasons to indicate that the study does very little to support that claim.

First, it is important to look at the goals of the study.  According to the author the goal were "(1) To increase the acceptance and use of long-term reversible contraceptive (LARC) methods among women of childbearing age  and (2) To measure acceptability, satisfaction, side-effects, and rates of continuation across a variety of contraceptive methods, including long-term reversible methods."  It was not an attempt to study whether increased access to traditional contraceptives would increase their use and effectiveness, but an attempt to convince women to change the type of contraception that was used.  This is very important, and almost never mentioned in the news reports.

Second, the study group itself is very interesting.  Dr. Michael New has mentioned that there was no control group to compare the study group to.  However, even more important is the characteristics of the group itself.  Women who volunteered for the project were recruited mainly from Washington University and various abortion and family planning clinics.  In order to be involved in the program, the women had to be desiring contraception and be willing to change the type of contraception that they were presently using (if any).  66% of the women in the program had previously experienced an unintended pregnancy, and 40% of them had a previous abortion.  39% of the women had a history of an STD, and 6% presently had an STD.

Is it possible that this group, who were already seeking contraception and most have experienced an unintended pregnancy, may be more willing and motivated to change their contraceptive method for this study?  Data extrapolated from this group of women cannot be accurately applied to the public at large, yet that is exactly what the news media would have us believe.

Lastly, the goal of the study was to convince women to forgo traditional methods of contraception (mainly OCs) in favor of more effective, long-term methods.  These LARC methods were IUDs or implantable hormonal contraceptives.  Over 75% of the women in the study were convinced to change from traditional methods to longer acting methods, and this accounts for the majority of the success in preventing unplanned pregnancies.   The challenge that the researchers had, and one that they were highly successful in this group, was to convince women to change from a non-invasive method of contraception to an invasive one.  There is no reason to believe that women in the general public, and especially teens, would be willing to choose these more invasive methods over regular OCs.  Convincing a 15 year old that is looking for a pill to have a 4cm implant placed in her or have this contraption placed in her young uterus will not be easy.

Anyone who doesn't think this won't be a significant barrier hasn't been paying attention to the other side.  For years, family planning clinics have been looking to stop requiring pelvic exams for women who are seeking contraception.

Indeed, according to a consortium of health-care providers and researchers, called Oral Contraceptives Over-the-Counter Working Group (OC-OTC), the annual pelvic exam is still a major barrier to access to contraception for many American women.
So lets get this straight.  Having a doctor perform a pelvic examination (for the benefit of the woman) is a major barrier to contraception.  Yet this study would have us believe that upwards of 75% of women would allow not only examine her "ladyparts" (with apologies to the Obama campaign), but allow the placement of a hormonally saturated contraption in her uterus, knowing that it would also have to be removed by a doctor at a future date when a pregnancy is wanted.  Good luck with that.
Bottom line: in a carefully chosen group of women, who may be highly motivated to change their contraceptive methods and avoid another pregnancy, LARCs may help them avoid pregnancy.  However, extrapolating that data to apply to the public at large, and especially including tradition types of contraception is not supported.  This study reveals nothing to believe otherwise.

Wednesday, October 10, 2012

LTI Podcast #30 - Free Plan B in New York HIgh Schools [Serge]

We're back again!  Jay, Rich and Megan discuss the new policy in New York public schools that enables children as young as 14 to obtain emergency contraception as well as long term contraception in school without parental consent or notification.  Is this the best we can do to train and protect our children?

Direct link is

or you can subscribe via ITunes right here.