LOVELAND MAGAZINE

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Tag: contraceptives

  • What if anti-abortion activists really wanted to reduce abortion rates?

    What if anti-abortion activists really wanted to reduce abortion rates?

    Birth control pills. Getty Images.

    Countries with more restrictions on abortion do not have lower rates of abortion

    A Guest Column by Rob Moore

    The U.S. Supreme Court’s landmark decision to strike down the right to family privacy around abortion care has cleared the way for Ohio’s six-week ban on legal abortion.

    Since about 1 in 3 women do not realize they are pregnant until six weeks or later, this bill effectively bans legal abortion care for a large number of pregnant women. 

    Ohio lawmakers are not stopping there, either. Boldly saying that pregnancies resulting from rape and incest should be required by the government to be carried to term, legislative leaders are pushing to ban legal abortion care in its entirety.

    This approach may come off as extreme in the face of its tepid support among the general public. According to the Pew Research Center, more Ohioans think abortion should be legal in all or most cases than those who think that it should be illegal in all or most cases. One in four women will have an abortion in their lifetime and most do not believe the extreme ontological claims about moral standing pushed by legislative leaders.

    A tragedy of legislative leaders’ efforts on abortion is how ineffective they will be at achieving their own goals. A 2017 cross-country analysis of abortion restrictions found that countries with more restrictions on the practice of abortion do not have lower rates of abortion. Believe it or not, interference with the private medical decisions of citizens is not only frowned upon in liberal democracies and beyond, it is also extremely difficult to do.

    Perplexing is legislative leaders’ ignorance of the decline of abortion over the past few decades. According to both the Guttmacher Institute and the CDC, the number of abortions in the United States have declined from a peak of about a million and a half in 1990 to less than a million in 2020.

    So what can legislative leaders do if they want to actually reduce abortion? There is one tool that has led to the reduction of abortion over the past decades that legislators could use that also do not infringe on personal medical decisions. That is improvement of access to contraceptives.

    Washington University of St. Louis researchers found that providing access to no-cost contraceptives cuts abortion rates by 62% to 78% among those who receive the contraceptives. Researchers at the Guttmacher Institute have found reductions in abortions are driven particularly by increase of use of long-acting reversible contraceptives such as intrauterine devices (IUDs), which have high success rates in reducing pregnancies and give women the ability to control when they want to become pregnant.

    A high-profile Colorado program providing long-acting reversal contraceptives to low-income women reduced teen births and abortions by 50% according to the Colorado Department of Public Health & Environment. In my graduate studies I worked with a team to conduct a cost-benefit analysis on a national version of this program, finding such a program would have benefits that would far outweigh its costs.

    Abortion is not going away. Even families that plan well find themselves in tragic situations where a fetus is unviable or the mother will die. Police state intervention is unlikely to be tolerated by families or effective in reducing abortion rates. But anti-abortion activists can reduce abortions if they want to: by increasing access to contraceptives that give families control over their reproductive health.

  • ‘Unequivocal nightmare:’ OB/GYNs fear uncertainty, health care delays post-Roe

    ‘Unequivocal nightmare:’ OB/GYNs fear uncertainty, health care delays post-Roe

    A medical exam room. File photo from MaxPixels.net.

    BY: SUSAN TEBBEN – Ohio Capital Journal

    Doctors fighting to keep their patients alive are worried about new abortion-related paperwork and legal advice that would hold up necessary care for their patients.

    Consulting lawyers and keeping complicated documentation is a part of life now that the U.S. Supreme Court overturned Roe v. Wade and Ohio put a six-week abortion ban in place.

    “If (patients) are in the midst of a pregnancy loss and a heartbeat is present… we then have to do the same paperwork for someone who was having an elective termination (abortion),” said Dr. Amy Burkett, an OB/GYN hospitalist in Northeast Ohio.

    Doctors face potential criminal charges and risks to their medical licenses because of what they say are unclear regulations and specifications on abortion. Beyond that, the changes to the health care landscape nationally and in Ohio create an environment where doctors who know a pregnancy isn’t viable may have to watch a parent carry the pregnancy anyway.

    “Being forced to go down the path is just an unequivocal nightmare, especially if you think of someone going through an entire pregnancy against their will when they know the fetus is going to die,” said Dr. David Hackney, maternal fetal medicine specialist in the Cleveland area, and chair of the American College of Obstetrics and Gynecologist’s Ohio chapter.

    Hackney, who works with high risk pregnancies and diagnoses birth defects, said abortion bans can increase the complication rate in pregnancies merely by increasing the number of pregnancies coming to term.

    As Roe v. Wade was overturned Friday and Ohio implemented its six-week abortion ban, Hackney was on call, and went to sleep that night unsure how he would proceed with medical care the next day.

    “It’s a Friday night, and all of a sudden the legal ground has changed entirely beneath my feet,” Hackney said.

    With cases that can include time-sensitive care and bleeding that must be dealt with urgently, Hackney said not having a plan in place can cause distractions with dangerous impacts on infant and parent health. That plan may now have to include referrals to other health systems, and even other states for legal options.

    “When it comes to a lot of these legal issues, the most important thing to have is a plan before something awful happens,” Hackney said. “We are even now still working out the details and trying to figure out processes.”

    Abortion bans could have impacts on pregnancy-related procedures that have nothing to do with abortion as well, according to doctors. Dr. Tom Burwinkel, a reproductive endocrinologist who also works on in-vitro fertilization, says bills like HB 598 — a proposed complete abortion ban in Ohio — could cause legal confusion and liabilities for facilities storing embryos or working with those embryos.

    Because the bill, which is currently sitting in a House committee, says an “unborn child” is defined at the time of fertilization, embryos that are damaged even accidentally or through natural occurrences in the IVF process could be held against the doctors conducting the work.

    “If we have embryos stored and something happens to the liquid nitrogen tanks, are the physicians and the people that own the facilities on the hook for the loss of thousands of embryos?” Burwinkle posed.

    Though IVF isn’t impacted by the six-week abortion ban, Burwinkle worries about the future of the IVF field and other pregnancy medicine, as laws and bills in the state focus on ideological ideas of life rather than the medicine involved.

    “Obviously the legislature wants to take things a step further … and that’s somebody imposing their religious beliefs on others. I thought this country was founded on religious freedoms,” Burwinkle said.

    Comments made by U.S. Supreme Court Justice Clarence Thomas in support of overturning Roe v. Wade are giving physicians further reason to be concerned about the future of gynecology, especially contraceptives.

    Burkett said it’s important for the public to understand that contraceptives are not considered abortion medication, even as legislation might couple things like Plan B with abortion-inducing drugs, and misinformation exists coupling IUDs with abortion.

    “IUDs are not considered abortion medications,” Burkett said. “Plan B is also not considered an abortion medication. Neither are medically considered abortifacients.”

    Misinformation about contraceptives does not just impact the public who may not have done enough research, but a part of legislation sponsored by non-medical professionals who may not be listening to the medical community. Hackney said ACOG representatives are always willing to serve as a resource for legislators.

    “In general, most of this legislation happens without meaningful, or certainly not with mainstream medical input,” Hackney said.

    Follow OCJ Reporter Susan Tebben on Twitter.