It’s a difficult reality, but it needs to be stated: a ruling in favor of Hobby Lobby could lead to more abortions. We recognize that this is a provocative statement. Our intention is not merely to get your attention, but to provoke thought. As an evangelical Christian, political science professor and a Jewish, family-planning physician we hope to shed some light on the consequences of an issue that has been at the center of too much partisan rancor and division.
The issues are birth control and whether private for-profit corporations can deny their employees coverage based on the religious beliefs of their owners. In just a few weeks, the Supreme Court will decide what the Constitution requires. We believe that whatever the court decision, faith-based businesses that value life should provide the full range of birth control options for their employees.
Bottom line: Contraception doesn’t cause abortions, it helps prevent them. A ruling allowing for-profit corporations to deny their employees contraceptive coverage would actually undermine increased access to the most effective ways to prevent unintended pregnancy and abortions.
In March, the court heard arguments from a $3 billion national chain of craft and home décor stores called Hobby Lobby. Along with nearly 50 other for-profit corporations that have filed suit, Hobby Lobby is demanding a similar religious opt-out from the contraceptive requirement in the Affordable Care Act that the Obama administration has granted to houses of worship and faith-based nonprofits.
Here is the irony: Although the owners of these for-profit corporations oppose the contraceptive requirement because of their pro-life religious beliefs, the requirement they oppose will dramatically reduce abortions.
First, we feel a moral obligation to clear something up. Misinformation and outdated research have bred confusion as to how exactly various methods of contraception work. Freedom of religion is too important for claims of conscience not to be based on scientific evidence.
To be clear: None of the contraceptive methods employers are required to cover under the Affordable Care Act cause abortion, including the specific types of contraception to which Hobby Lobby objects. Instead, these contraceptive methods work by preventing pregnancy (fertilization) from occurring in the first place. For instance, the intrauterine device works primarily by preventing fertilization. Plan B (or the progestin-containing, morning-after pill), along with Ella (ulipristal acetate), delay the release of a woman’s egg from her ovary. The egg does not get fertilized, which means the woman does not become pregnant.
In fact, long-acting contraceptive methods, such as IUDs and implants, are the most effective forms of contraception for preventing unintended pregnancies. And preventing unintended pregnancy is key for those who identify as pro-life, because almost half of all unintended pregnancies end in abortion.
Until contraception without a co-pay was included in the Affordable Care Act, the main barrier to widespread use of the most effective contraceptives has been cost. An IUD costs around $700, which for many families is prohibitive. Imagine a married evangelical woman and her husband making the prayerful decision not to have additional children. Imagine that the woman works for a for-profit corporation, but her boss objects to IUDs. Allowing the employer’s beliefs to deny a woman’s access to the method of contraception recommended by her doctor puts a heavy and unfair burden on the woman and her family’s well being.
The St. Louis Contraceptive CHOICE Project demonstrated that we are not just talking about a difference at the margins. Investigators at Washington University School of Medicine enrolled almost 10,000 women at-risk for unintended pregnancy. When they were given their choice of birth control methods, counseled about their effectiveness, risks, and benefits, with all methods provided at no cost, about 75 percent of women in the study chose the most effective methods: IUDs or implants.
As a result, annual abortion rates among study participants dropped to approximately 50 percent to 80 percent below the national abortion rate.
Recent data from the Guttmacher Institute indicates that the U.S. abortion rate is at its lowest since the 1970’s. The contraception mandate could very well reduce the abortion rate to its lowest point on record.
Imagine a million fewer unintended pregnancies. Imagine healthier babies, moms and families. Imagine up to 800,000 fewer abortions. No matter your faith or political beliefs, our hunch is that we can all agree that fewer unplanned pregnancies and fewer abortions would be a blessing.
Julia K. Stronks J.D., Ph.D is the Edward B. Lindaman Chair at Whitworth University in Spokane, Wash. Jeffrey F. Peipert, M.D., Ph.D. is the Robert J. Terry Professor of Obstetrics & Gynecology at Washington University School of Medicine in St. Louis.