Privilege and The Pill


by Rachel Held Evans Read Distraction Free
'Not 100% Effective' photo (c) 2008, Nate Grigg - license: http://creativecommons.org/licenses/by/2.0/

In my relentless pursuit of scaring off as many readers as possible this year, I’m blogging today about contraception.

I try not to put too much pressure on myself to speak up as the token “Christian feminist” on issues like these, but after reading multiple blog posts and articles this week from Christian men about women and contraception, I decided to add my two cents as a pro-life woman of faith who supports affordable access to birth control for women.  Just to offer another perspective. 

(This is obviously an issue in which people of strong faith disagree, so let’s treat one another with respect as we engage, shall we?) 

The topic has been in the news lately for a lot of reasons—from the anniversary of Roe vs. Wade last week, to Hobby Lobby’s challenge of the HHS mandate last year. Mike Huckabee made the news days ago for tackling the topic in a speech to the Republican Nation Committee, where he suggested that women who expect health insurance to cover birth control pills as it would any other prescription believe the Democrat-manufactured lie that they are “helpless without Uncle Sugar coming in and providing for them a prescription each month for birth control because they cannot control their libido or their reproductive system without the help of government.”

His comments may strike some as too outrageous to engage, but I think they reflect widely-held (thought not typically as crudely-stated) sentiments regarding birth control, sentiments I’ve seen expressed more and more often by fellow Christians in recent years. And I think they reflect a problem of privilege that plagues conversations around contraception, infusing them with misinformation and unhelpful assumptions. 

Birth control should be an important topic to those of us who consider ourselves pro-life because the most effective way to curb the abortion rate in this country is to make birth control more affordable and accessible.  

Abortions happen because of unwanted pregnancies, and often, unwanted pregnancies happen because of lack of contraception. Most women who choose to have abortions do so because they feel they cannot manage the financial burden of carrying out the pregnancy and raising another child. So understanding the economic and health concerns of women of childbearing age is critical to actually affecting change when it comes to abortion instead of just talking about it. 

….Which brings me to the first problem of privilege around the contraception conversation: economic privilege. 

Economic Privilege 

The most effective forms of birth control are also the most expensive, which is why a lot of families welcomed the Affordable Care Act’s requirement that private health insurance plans begin to provide birth control without co-pays or deductibles. 

But Huckabee and those who oppose this measure argue that unlike other prescriptions, prescriptions for birth control are luxuries that women should be able to pay for on their own, without help from their insurance companies. 

But birth control costs an average of $600-$1,000 a year—and sometimes quite a bit more, depending on the type. Now, $1,000 a year might not be much for someone like Mike Huckabee, but for a lot of families in this economy, working minimum-wage jobs that barely cover the rent, it’s a steep enough price to sometimes put them in the position of having to choose between paying for contraception and paying the water bill. 

And a woman who cannot afford birth control is more likely to consider herself unable to afford a pregnancy, which makes terminating that pregnancy seem like the best, most affordable option. And the cycle continues. 

So those who oppose coverage of birth control based on their religious or pro-life convictions must take into consideration the fact that lack of coverage may actually lead to more abortions. And we must remember that shrugging off birth control as something people should be able to easily pay for on their own betrays some of our own economic privilege in this conversation. 

(For an interesting global perspective on contraception, be sure to check out Rachel Marie Stone’s post on the topic, where she cites this powerful statistic from USAID:  “Family planning could prevent up to 30 percent of the more than 287,000 maternal deaths that occur every year, by enabling women to delay their first pregnancy and space later pregnancies at the safest intervals. If all babies were born three years apart, the lives of 1.6 million children under the age of five would be saved each year.”) 

Male Privilege 

I realize that phrase makes the hair stand up on some people’s arms. But bear with me for a moment. 

When male politicians or pastors speak about women and contraception, they sometimes make generalizations that reflect a lack of experience. 

For example, it is wrong to assume that the only reason a woman would be on the pill is because she has an "out-of-control libido" (what does that even mean?) or because she wants to sleep around without consequence.  The fact is, married women are much more likely to be on the pill than unmarried women, and most say they are simply trying to space out their pregnancies or wait until they are more financially stable to start a family. 

Furthermore, a man cannot possibly understand what it is like to suffer from endometriosis—an incredibly painful chronic condition that affects more than five million women in the U.S. and in some cases can be treated with birth control pills. (To learn more about this condition, check out R.A. Sovilla’s candid and informative guest post on the topic.) 

A man cannot know what it is like to experience debilitating menstrual cramps once a month, or to be told by a doctor that, because of some other health condition, pregnancy is inadvisable—other common reasons women are prescribed oral contraception.  He cannot fully understand what giving birth does to the body and why spacing out children may be so important to a mother. 

Men don’t know what it means to be raped and to face the prospect of pregnancy as a result, a situation in which the morning after pill can prevent a pregnancy without causing an abortion.  And while this is thankfully changing, the fact remains that women are the most likely to be forced out of work because of pregnancy, and to carry the heaviest load (literally!) in balancing work and family, so it is hard for men to fully comprehend what pregnancy means to a woman. 

I would never go so far as to say that men should be forbidden from discussing contraception simply because they are men. But I think that if more women were given the opportunity to weigh in, the discussion would at least be a bit more nuanced and informed. (I have a feeling we’d hear a lot less about “Uncle Sugar,” “legitimate rape,” and these mysterious female powers that can “shut that whole thing down” if necessary.)   

Most women in the U.S. have used a form of oral contraception at some point in their lives. It might be worth asking them why. 

Misinformation About The Pill  

Finally, a note about misinformation regarding birth control and abortion. 

When I first got married, I never heard a word from my evangelical community against birth control pills. Not a word. It was just assumed that oral contraception was an acceptable form of family planning and in no way related to abortion. But about five years into my marriage, I started hearing rumors from other women, which they had heard from pastors and pro-life organizations, about how birth control pills cause abortions.  I talked with more and more friends who were convinced oral contraception was immoral.  Many of them stopped using birth control altogether. But these rumors were based on misinformation. 

With most oral contraception, a woman takes a daily pill, usually a combination of estrogen and progestin. The hormones prevent ovulation and thicken a woman’s cervical mucus, blocking sperm from fertilizing an egg.  (Of course, hypothetically, there’s the very remote chance that fertilization will somehow manage to occur. In this case the zygote may fail to implant on the uterine wall. But, as Libby Anne points out here, this happens naturally in women who are not on the pill far more often than it happens to women who are on the pill.) 

Another popular rumor is that the so-called “morning after pill,” or Plan B, causes abortion. Christianity Today recently refuted this argument, citing multiple scientific studies that confirm Plan B does not inhibit implantation but instead blocks fertilization. 

(Rabbit trail: The fact that a woman’s body naturally rejects hundreds of fertilized eggs in her lifetime raises some questions in my mind about where we draw the line regarding the personhood of a zygote. Do we count all those “natural abortions” as deaths? Did those zygotes have souls? Will I meet them in heaven? Honestly, the more I learn about the reproductive system, the harder it becomes for me to adamantly insist that I know for sure the exact moment when life begins. And it’s even harder for me to insist that everyone else agree.)

As we discuss contraception, Christians especially must be committed to telling the truth and getting our facts straight, or else we risk losing credibility in the conversation and leading the faithful astray. 

Conclusion

In conclusion, let’s talk about contraception. But let’s talk about it accurately and with our privilege in check. Let’s avoid making generalizations about the millions of women and families who say they would benefit from affordable, accessible contraception. And when we are blessed with a podium or pulpit, let’s speak about our fellow human beings with love and care and without sloppy attempts to speak for them. 

….Oh, and let’s agree to never, EVER use the phrase “Uncle Sugar” again. 

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