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REPRODUCTIVE HEALTH

Contraception Is the New Abortion

The Latest Right Wing Trend? Attack Birth Control

Birth control SOURCE: iStockphoto A proposed HHS rule would alter the meaning of the word “abortion.” If implemented, our best tools for preventing the need for abortion would suddenly be redefined as abortion.

The Bush administration has taken its latest swipe at contraception, but again under the pretense of opposing abortion. By manipulating scientific facts, the Department of Health and Human Services hopes to enshrine in federal law a conservative, ideological interpretation of pregnancy that has the potential to significantly limit women’s access to contraception.

In 2004, Congress passed a budget rider commonly known as the “Weldon Amendment,” named after its sponsor, Rep. Dave Weldon (R-FL). This provision prohibits recipients of federal funds from “discriminating” against individuals or institutions who, due to reasons of conscience, refuse to provide abortion services, coverage, counseling, or referrals, even in an emergency.

Although the Weldon Amendment already places substantial obstacles in the way of women seeking reproductive health services, the Bush administration did not want to stop with abortion. In an eleventh-hour gift to radical right organizations, who have been pressuring the administration to cut family planning funding, HHS has proposed a regulation implementing the Weldon Amendment that would vastly expand its scope.

This is just the most recent attempt in a longstanding campaign by social conservatives to turn discomfort with abortion into opposition to contraception.

The proposed rule defines abortion as the termination of pregnancy from the point of conception: “the Department proposes to define abortion as ‘any of the various procedures—including the prescription and administration of any drug or the performance of any procedure or any other action—that results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation.’”

This marks the first time the federal government has proposed a departure from the well-established medical definition of pregnancy. The mainstream medical community, including the American Medical Association and the American College of Obstetricians and Gynecologists, defines pregnancy as beginning with the implantation, not creation, of a fertilized egg.

The upshot of this revised definition is that any form of contraception that may interfere with the implantation of a fertilized egg could be categorized as a form of abortion. This means that any health care entity or provider, on the grounds of their opposition to abortion, could refuse to provide women with access to 40 percent of the most commonly used methods of birth control in the United States—the pill, the IUD, emergency contraception, the patch, the shot, and the ring. In other words, our best tools for preventing the need for abortion would suddenly be redefined as abortion.

This is just the most recent attempt in a longstanding campaign by social conservatives to turn discomfort with abortion into opposition to contraception. Instead of being upfront about their genuine, but unpopular, position that contraception is morally wrong, right wing groups have tried to confuse people into thinking that the most common forms of birth control used by women actually cause abortion.

Virtually all women of reproductive age who have had sexual intercourse—98 percent—have used at least one method of contraception. Almost 15 million women in the United States use hormonal contraception or an IUD. Are we really prepared to let health insurance companies, hospitals, health clinics, and health care providers of all stripes tell these women that they are potentially having an abortion every month and deny them access to routine medical care?

There are good scientific reasons why medical professionals define pregnancy as beginning at implantation rather than fertilization. For one thing, there is no way to know if a woman is pregnant prior to implantation. The body simply does not give off any signals of pregnancy (e.g., increased hormone levels or an expanded uterus) until then.

In addition, nature has made it clear that not every embryo is meant to develop into a fetus and eventually be born. It is estimated that 31 percent of all pregnancies end in miscarriage, often before a woman even knows she’s pregnant. And anywhere from one-third to one-half of all fertilized eggs never begin or complete implantation.

Anyone familiar with fertility treatments understands this basic principle. Most people would recognize that an embryo in a Petri dish does not constitute a pregnancy. And placing an embryo in a woman’s uterus does not automatically make her pregnant. There are plenty of women who have tried several rounds of in vitro fertilization but, sadly, are unable to get pregnant.

Even if we were somehow able to detect the presence of an embryo before implantation, when exactly would “conception” occur? The process of fertilization itself can take up to 24 hours. The zygote then begins to divide and differentiate into the preembryo and travels down the fallopian tubes toward the uterus. Implantation of the preembryo into the uterine lining typically begins about 5 days after fertilization and will be completed between 8 and 18 days after fertilization. Thus, despite the assertions of social conservatives, there is no one “moment” of conception.

Notwithstanding all these scientifically inconvenient facts pointing to the need to define pregnancy as beginning at implantation, the HHS regulation would allow individuals or institutions claiming its protection to provide their own definition of pregnancy and abortion. The proposal states, “[T]he conscience of the individual or institution should be paramount in determining what constitutes abortion….”

That means that within each hospital, health clinic, or health insurance program that receives federal money, each employee would be entitled to decide when he or she thinks pregnancy begins and refuse services based on that definition. Women would have no guarantee of receiving consistent medical care based upon their personal needs and circumstances. Rather, the treatment they receive could vary from one hospital, health insurance program, and health care provider to the next.

The ultimate catch-22 of course is that if we cannot determine if a woman is pregnant, then we can treat all women as potentially pregnant—and refuse them access to drugs and devices that would help them prevent pregnancy. Does your brain hurt yet?

This is hardly the first time the Bush Administration has shown its disdain for science and medicine (see climate change, abstinence only programs, and Vioxx) or for contraception (see Susan Orr, Plan B, and UNFPA funding), but let’s hope it’s the last. We must work to ensure this latest trend doesn’t become our reality.

Jessica Arons is the Director of the Women’s Health and Rights Program and a member of the Faith and Progressive Policy Initiative at the Center for American Progress.

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