could the emergency contraception decision make sense?

I feel obliged to comment on the jaw-dropping stupidity of the recent actions of the Obama administration regard access to emergency contraception.

I’ve been trying to work out what the administration gains from this betrayal of science and public health, because I simply cannot tolerate the idea that someone as intelligent and clear-thinking as Obama really BELIEVES that this is a “common sense” decision that makes sense to him as a father of two girls. That’s BULLSHIT. It’s got to be political.

So. I investigated some.

Rates of abortion among girls aged 15 and under is less than one per 10,000, compared with around 1 in 1,000 among girls aged 15-17 (these two groups combined represent about 6.4% of all abortions performed) and slightly over 2 per thousand among girls aged 18-19, according to the Guttmacher Institute. So the public health impact on reducing access to effective contraception is far less than, say, the impact of not allowing it for OTC sale to women over 17, which is what the Bush administration did until 2006, three YEARS after the FDA advised that it was safe.

This is not to minimize the importance of reducing barriers to access to girls under the age of 17. If you’re that girl whose condom broke or whose partner forced you to have sex without a condom or who can’t ask your parents about getting birth control, then being able to walk into a store, pick up a box, and buy it, is TOTALLY CRUCIAL. (Though, as Cora Breuner points out in the Time article linked above, how many of those girls have $50 to buy EC?)

But say you’re a president. And say you want to make a public decision that will make you look good to people who don’t know much about these issues and are much better at being scared of young people’s sexuality than they are at being compassionate toward young people who have sex – because those ignorant, non-compassionate people are swing voters – but you want to do it without actually fucking up public health outcomes in a major way.

You’re not significantly increasing the pregnancy rate or the abortion rate, as measured at the population level, because those girls represent such a small proportion of the abortions performed in the U.S. And you’re not even meaningfully increasing the pregnancy rate, since access to EC is not correlated at the population level with reductions in the pregnancy rate. It’ll be easy to point to data that show that no harm was done.

And in 2012, when you’ve been elected for your second and final term, you can reverse the decision, with someone brilliant like Elizabeth Warren in the wings, knowing that the number of girls who suffered over the previous 11 months is a drop in the bucket compared to the number of women and girls who would suffer under any of the Republican contenders’ administrations.

(FYI: a handy summary of the age-and-EC research by RHTP (PDF).)

I’m not trying to be an apologist here – the decision is fraudulent and a vicious strike against both science and women’s reproductive health and rights. It’s BULLSHIT and it makes me angry. But I’ve respected a great deal of what the President has done, especially the measured, patient, and collaborative approach he has brought, even when the Republicans didn’t (in my view) deserve such respectful treatment. He’s Melanie Hamilton to my Rhett Butler: he’s all the things I can never be but that I respect as good and decent. So what in the world could induce Melanie Hamilton to support such a stupid decision?

Long-term harm reduction.

It’s an idea.

But don’t let this idea stop you from calling your representative, your Senators, and the white house, to explain to them that it’s BULLSHIT. BULL. SHIT.

30 responses to “could the emergency contraception decision make sense?

  1. All of this makes sense. And I get it. But still. so. ragey. . That kind of language–preventing access as “Common sense” as a “Father of two girls” –only perpetuates the notion of women and girls as property of the men in their life. Coming from an apparently liberal president makes me sick to my stomach. I hope the Secretary of State or Mrs. Obama is as secretly pissed about this as I am openly pissed about this.

  2. This is an example of the dangers of paternalism that I was arguing against when you were arguing for banning Flibanserin:

    http://enagoski.wordpress.com/2010/06/01/sexual-justice-action/

    From the perspective of the people who oppose making “morning after” pills OTC, it seems obvious that 12 year old girls should be prevented from getting chemical contraceptives without parental permission, just as it seemed obvious to you that women should be protected from those evil pharma companies.

    If the FDA and other regulatory bodies did not have the power to ban the sale of drugs, then this wouldn’t be a political issue in the first place, and women could’ve bought “morning after” pills (and birth control, and RU-486, and on and on) OTC long ago. Not to mention all the drugs that don’t exist at all because getting FDA approval is so costly. (For example, men would probably have effective chemical contraceptives by now).

    • No without the FDA it would be a commercial profit-driven issue, and though I have deep frustrations with the government, that’s nothing compared to my horror at the atrocities that corporations will commit in the name of profit.

      • The FDA requires that a new drug be proven both safe and efficacious before it’s allowed on the market, a standard which you appear to agree with. So, presumably, given your strong feelings on the matter, you can point me to the studies of that show that the FDA itself is safe and efficacious?

        After all, there are two types of errors that the FDA can commit–1) It can allow a net harmful drug on the market 2) it can prevent a net benefit drug from reaching the market. You seem to be most concerned about errors of 1), but the mortality/morbidity from type 2) errors are equally bad, right?

        And if it turns out that such studies have not been done, or they show that type 2) errors predominate, then shouldn’t those laws be repealed until such time as they’ve been shown to be both safe and efficacious?

  3. wow, I’m impressed you could find a positive perspective on this – props!

    But yes: still BULLSHIT.

  4. Obama “intelligent and clear-thinking.” Surely you jest. Don’t be taken in by word tricks – he’s as slippery as they come.

    • We elected Friedman in Keynes’ clothing. It’s ineffably sad.

      • Milton Friedman advocated for the the repeal of the FDA and medical licensure. Obama may be Friedmanesque in other respects (though I can’t think of any major policy position of Obama’s that Friedman would’ve approved), he certainly is not Friedmanesque with respect to medical freedom.

  5. emily, thanks for this. i am hoping that this was a bargaining chip in the war the administration is currently in with the bishops about sex trafficking grants and contraceptive insurance coverage, both of which matter, to me, far more in the grand scheme of things. if they give in on those too then i’ma lose my $hit though.

  6. Let me get this straight, you are making pro Bush statements and anit Obama statements. Music to this old conservative’s ears. Blessings on you and yours. We can agree on something.
    John

    • No. You’ll notice I made an anti-Bush statement, to contextualize how much less-bad than Bush this particular decision is. And the purpose of the entire post is to try to figure out why such a good president (Obama) would support such a bad decision; I am motivated to figure this out because I like Obama so much. So we still don’t agree on anything.

  7. Geez what is there to like. He lied repeatedly and on stuff that he did not have to lie about like having the health care negotiations broadcast on C Span that even right wingers like me supported. Just google the phrases the lies of Obama and the broken promises of Obama and it goes on for pages. Recall that we rightly threw out Bush Sr for ONE BROKEN PROMISE. I believe in MLK’s Dream Speech and judge Obama not on the color of his skin but on the content of his character. Lying is listed as an abomination to God in Proverbs 6.

    This guy has overtaken Carter as the worst president in our history. He LAUGHINGLY ADMITTED that he lied about “Shovel Ready” projects in an interview with the NY Slimes It goes on and on
    John Wilder

  8. The fact that someone who needs it might hypothetically be unable to afford it is no argument for making hir hypothetically unable to buy it because of hir age.

    I started babysitting at age 13, as did a lot of my friends, and real jobs started around 15 or 16, which is still under 17. And 40-70 bucks is still easier to beg, borrow, or steal than the time and costs of visiting a doctor, or an abortion…It won’t be available to everyone, OF COURSE, what is? But it’s one less barrier.

    • And when a contraceptive is OTC, it is opened up for subsidies and programs to make it available even to those without the savvy to scrounge the fifty bucks.

      God, this “common sense” argument is such bullshit and makes me so angry. Common sense should not be basis for policy decisions! Common sense is unreliable, myth-ridden, unscientific, and logically appalling! And that’s the argument FOR this decision! Cheez-Its, how infuriating can an appointed official BE?

  9. Emily for President.

  10. If it’s politics it’s not working. No right wingers think he’s really on their side on anything.

    This is poor on his part :(

  11. Yeah, it’s pretty obviously political, and there’s no group of people Obama won’t throw under the bus in pursuit of maintaining oligarchy.

    But what puts it over into inexcusable is Obama doing science denialism about the stats to cover for it. This is up there with is DOJ arguing that all gay folks are pedophiles. In a general sense, it’s pretty clear that the macho, boy-oriented Obama Administration has trouble with anyone who isn’t a cisgendered man.

  12. You’ve brought up an interesting note for me–just from my anecdata, it’s been incredibly common for folks I might identify as “very progressive” to attribute secret progressivism to Obama. Whenever he articulated a center-right position during his first run for office, I heard a refrain everywhere of “He’s just saying that to get elected, he’ll turn into a super-progressive when he gets into office.”

    I see it in writings too. This right-leaning business is all a clever ruse, there’s a secret Obama underneath who’s really with us, etc. I think part of it four years ago was that people confused the big progressive victory of electing a black president with the big progressive victory of electing a progressive president.

    To my mind, he’s been frustratingly honest the entire time: I don’t recall him ever claiming to be something other than a center-right, fairly militaristic business president, and I don’t recall him doing anything out of line with that. I think he’s just doing a terrifyingly good job of being the right-leaning Democrat he is.

    • Obama’s behavior is certainly within the Progressive tradition. Progressives, as a rule, have no principled opposition to paternalism. After all, Emily has written approvingly of using state power to prevent women from buying drugs that _Emily_ doesn’t think they should have. Do you think that regulators will always make a decision you agree with? And is it all that shocking that a political institution, run by political appointees, would take politics into account when deciding what drugs to release?

      • Paternalism is not something that divides the left from the right, it’s something that divides the representative democracy folks from the anarchists.

        It’s not blocking access to drugs that makes Obama a slightly right-wing centrist (along with being pro-death penalty, pro-privatization, and disastrously anti-immigrant) it’s deciding who has what reproductive rights. The question at hand is not whether a politician takes politics into account when making decisions; it’s which politics they’re going to take into account. In this case, I would argue that Obama is doing center-right politics, not progressive politics.

  13. As a citizen of Sweden, I am quite amazed by the fact that the author of the Times-article thought that it was relevant to explain what a morning after-pill is. The US is really a world of its own.

  14. @lestin Paternalism is not unique to Progressives, it’s true. Is this paternalism “progressive paternalism”? If you were to look at the progressive tradition from say, the late 60′s to the present, I would say no. But if you look at the broader history of progressivism, it’s only within the last half century or so that progressives have largely given up trying to control other people’s reproductive behavior both for their own good, and for the good of society:

    http://www.ncbi.nlm.nih.gov/pubmed/2698847

    Even now, their support for an individual’s “right to choose” only extends to certain reproductive decisions. God help you if you want to take a medicine not approved by government regulators, or seek medical advice from someone outside the medical unions. So, while the Obama administration’s decision in this case runs against the narrow set of medical decisions that progressives currently do think should be left up to the individual, it is well within the historical progressive tradition.

  15. Obama is not the friend of any woman in this country. He has continually thrown you, me and every other woman in this country under the bus in an effort to pander to the religious right in this country. Well there is no getting along with those fools. If you think that womens’ uteri should all be controlled by a crazy man who was talking to a nonexistent god who was telling him to die for all of the things this god didn’t like in the world you are one seriously fucked up person and your god is even more so. Why do we give these people any kind of clout? They believe in a despicable atrocious thing and we continue to allow them to act as though there is nothing wrong with it. I for one will not sit by and allow their bigoted horrible viewpoint to hurt me and mine. We need to treat the christian right as the extremist terrorists that they truly are instead of giving them a national platform and treating them like legitimate activists. We should not give a platform to people who choose to not be capable of rational thought. We don’t treat the KKK like legitimate activists (another group who chooses not the be capable of rational thought) and it’s time that we start doing the exact same thing with the religious right.

  16. Hey Rebekah
    What a perfect example of hate speech. Christianity is the only religeon that it is okay to discriminate against in a liberal’s eyes. Would you say the same things about Judaism or worse yet Muslims?

    For the record you libs rant against hate speech and yet you are by far the most egregious offenders of this horrible slander.

    To equate the religious right with Terrorists is irrational. When is the last time that you have seen the religious right killing innocent people by blowing them up? We operate entirely inside the law and are law respecting honest people with a conscience that we are entitled to according to our Declaration of Independence.

    John Wilder

    • When is the last time that you have seen the religious right killing innocent people by blowing them up?

      Um. http://en.wikipedia.org/wiki/Anti-abortion_violence

      • I read the wiki entries. These were some nut jobs not approved by the mainstream right to life movement of which I have been apart of since the early 1970′s. Certainly nothing on the order of black violence in this country and certainly not anywhere near the Muslim violence. These are isolated incidences but your point is taken. Main stream Christianity does not support violence in its cause for the unborn. While tragic it is a small handful of people killed or injured less than a 100.

        On the other hand how many multi millions of unborn children have been murdered in the most gruesome fashion since Roe V Wade. It is in excess of 40,000,0000. If you dismembered an unwanted puppy by cutting him into pieces while alive the liberals would go BERSERK.
        John Wilder

  17. First of all I’m a libertarian, not liberal, not progressive, not a social democrat or what have you, so don’t just assume that you know a damn thing about me. Second of all, I do not support any kind of religious zealotry whether the person spouting it is christian muslim, jewish or whatever other religion that gives people the excuse to be horrible bigots. That means that I don’t have a problem with all people of any religion (this includes christianity), just the ones who use their belief structure to hurt other people. The reason that I brought up christianity in this specific regard is because I don’t see a whole bunch of people from any other religion attacking womens’ freedom of self or any one of the other harmful things that I see a whole bunch of christians do all the time.
    Third, It’s not hate speech to call you irrational and to call out your horrible bigotry. You as a christian are so used to everyone bowing down and kissing your ass that you think when the rest of us expect some fucking equality that you are being discriminated against. I refuse to kiss the ass of anyone let alone kiss the ass of a bigot.
    Fourth, the definition of a terrorist is one who seeks to inspire fear in others by committing violent acts. The religious right wants it to be a crime to be gay. They teach their children to torture QUILTBAG students and presumed QUILTBAG students until those students end their own lives. The religious right attacks people who use planned parenthood’s services even if those people are not there to get an abortion. They bomb abortion clinics and shoot doctors. They create a hostile environment which gets their opponents shot.
    Fifth on top of those three things above ( last time I checked murder, accessory to murder, and arson are felonious crimes) the religious right has also started a fucking religious war. The MURDER of every civillian and soldier on both sides are on the shoulders of the religious right. You are responsible for the deaths of more people than I can begin to count. When the law doesn’t work in your favor (aka when the law stops you from being bigoted assholes) you rewrite the law. Your actions are not legal, they are just painted over with excuses which somehow magically make them legal.
    Oh and one last thing the declaration of independence does not grant “entitlement to a conscience” since it is assumed that you already have one. In fact it does not grant entitlement to anything especially since it’s not a law signing document.

  18. Rebekah
    Your ignorance is showing as well as your own bigotry.

    Christians don’t want to make it against the law to be gay, the only thing that they want is for gays to have civil unions and not call it marriage which is reserved for a man and a woman which Obama even supports.

    I don’t expect anyone to kiss my ass but to offer respect for my point of view even though it conflicts with yours.

    The Bill of Rights (Imisspoke earlier, my fault) grants us a primary right the right to life. We have allowed women to become God on earth deciding if an unborn child is a baby or not. For example, if I hit you with my car and cause you to have a miscarriage and you wanted the baby then I will be charged and prosecuted for the crime of vehicular manslaughter but if you don’t want it then you decide that it is not a baby. It is even worse, the only difference between first degree murder and legal abortion is 4 inches (the diameter of a babys head) which is turned into the breah position against all known priactice of OB/GYN and the doctor then stabs the baby in the skull in the birth canal and sucks out its brains. If the baby slips out and then the doctor does it is first degree murder but because the baby’s head is in the birth canal (even though the rest of the baby has been delivered) then it is legal abortion.

    In law, you will be charged with destroying an eagle egg ( a potential eagle in pro choice terms) and be fined $100,000 and spend 5 years in jail but if you kill a baby then it is legal abortion. Kind of schizophrenic when you view it in these terms.

    There has been only one doctor shot which all christians disavow and that was a nut case not a main stream christian. Same thing with abortion clinics. The right does not attack women utilizing Planned Parenthood Clinics (the biggest single provider of abortion out there and their main business and cash cow.

    Surely you can’t believe even your own rhetoric that all christians are like the lunatic few, if you do then you are so blinded by hate that you can’t see anything else. I have spoken to you with respect and have not called you names but have quetioned your rhetoric as flame throwing and bombastic. This is something that most liberals and libertarians do, insult, denigrate, castigate and name call to try and verbally assault your victims into silence. You never gain aggreement with these tactics and are so common in Communist countries.

    I will not be silenced or intimidated by your hate speech. Because we have freedom of speech you get to do it but it does not make you a good advocate for your cause.

    Blessings on you and yours
    John Wilder

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