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Feb 22 2013

Reducing Abortion

Richard M. Doerflinger’s article on Washington Post has me intrigued. How do you reduce abortion?

From a medical standpoint? Abortion can be a medical or a surgical procedure, each with specific risks. If we can control and totally reduce unwanted pregnancy we can eliminate these risks.

This doesn’t mean reduce the access to abortion, this means “improve contraception”.

A key discussion was among those invited to advise the new administration’s faith-based office. But pro-life participants soon found what they saw as a bait-and-switch. Pro-choice participants, joined by White House staff, were not willing to speak of “reducing abortions.” Instead they wanted to “reduce the need for abortion” — that is, reduce unintended pregnancies, chiefly through expanded contraceptive programs. Catholic representatives could not in conscience endorse the changed goal, as their moral teaching neither approves contraceptives nor sees an existing “need” for abortions.

Ah… to clear a standpoint! Richard is the Associate Director of the Secretariat of Pro-Life Activities, U.S. Conference of Catholic Bishops.

Richard wants less abortions but doesn’t want to reduce the need for them. In Plain English? Richard doesn’t want improvements and access to contraception coverage, he wants it to be harder to get an abortion. In short? He is an idiot. We can actually reduce actual abortion through reducing the need for abortion. What Richard and his Catholic Bishops want is an INCREASED need for abortion but a reduced access to abortion. This isn’t pro-life, this is the Coathanger Lobby.

Less well known is the fact that contraceptive programs often fail miserably at reducing unintended pregnancies or abortions — and can be associated with increased rates of sexually transmitted diseases, including AIDS. In a major meta-analysis by proponents of “emergency contraceptives,” out of 23 studies of programs to enhance access to those drugs, not one could show a reduction in unintended pregnancies or abortions.

I am afraid the United States Conference of Catholic Bishops aren’t a valid source of information on contraception on the basis of their forte is “belief in a supernatural being”.

The WHO, MSF and Red Cross however fucking are. If you think this bullshit is harmless? Guess again. I found this article printed out in India. Where we are fighting a massive fucking population explosion so vast that the effort to reduce it is frankly gargantuan. If India had a third of the population that it has now it would have a colossal improvement to standard of living. It would be a first world nation. A lot of the issues in India is that there is no infrastructure physically capable of handling so many people. To flog this bullshit here (I had to google up the piece to link it to you) is deadly.

You see? At the bleeding edge of healthcare family planning saves lives. It stops starvation disorders. In addition proper spacing improves child health. In addition fewer births reduces maternal mortality. This bullshit is flogged here and often flogged as ethnic cleansing. That’s right. I have heard propaganda claiming that Contraceptives are a Hindu plot to destroy Catholics (and Muslims) by reducing their birth rates. Honestly when people like Richard say bullshit like this, I want to throw stuff at them. Because people say “What Harm Do They Do?” and don’t believe it when I say “THIS!”.

I know the study that the second link is about. It shows that the emergency contraceptive pill systems in use do not reduce unintended pregnancies.

Of course they don’t. That’s like suggesting that band-aids reduce injuries. The point of EC is to prevent the implantation of a fertilised egg. You are ALREADY PREGNANT at this stage when you take it, your body hasn’t recognised it yet. It would be categorised as an unwanted pregnancy because if you wanted it you would NOT TAKE THE PILL.

Condoms, Intra-Uterine Devices, Oral Contraceptives and Depot Contraceptives are what reduce abortions. They are fantastically effective.

An alleged exception to the rule is a recent “Contraceptive Choice” study in St. Louis. The organizers abandoned all pretense of “nondirective” counseling, offering over 9,000 women free contraceptives while specially promoting long-acting methods like hormonal implants and IUDs. They persuaded most of the women to accept these more aggressive methods, which make a woman sterile for years and cannot be removed without a doctor’s help, and periodically followed up to make sure they stayed with the program. They showed significant reductions in pregnancies and abortions, proving only that sterilized women don’t get pregnant. It’s been harder to find data on adverse effects or rates of STDs.

Non-Directive Counselling can go fuck itself. You cannot be polite in this conversation because frankly you are suggesting the equal to doctors and people who do this for a living are some guys whose only qualification is how much they believes in a specific god.

Put it this way. When you hire an electrician or a plumber you ensure you hire a real one. You wouldn’t ask me to do your plumbing despite the fact that I can make a cut so fine on a human eyeball that it is self closing. I can literally hit the centre of a vein through your skin. However you know as well as I do that these skills while fine for a doctor are terrible on a plumber or an electrician. I know too.

Yet there are people willing to listen to priests about how we should engage in faith healing when it comes to abortion.

And it shows. Sterile for years?

He is talking about the IUD which is a little medicated plastic insert placed into the uterus. It’s uncomfortable to put in but once placed will provide a seriously effective long time contraceptive with minimal risks. (Mainly? Pelvic inflammatory disease and ectopic pregnancy). It’s the only one on the list of contraceptives that requires medical aid to continue and has a long term effect.

When we talk about science we have to remember public perceptions of science. The words and language we use is important. Sterile is what we use when we discuss “permanent” solutions to birth control. Tubal Ligation and Vasectomy are both “sterilisation” procedures. To use the language of them to apply to temporary birth control is “malicious”.

It’s temporary and while many women don’t like the IUD’s insertion and removal, I have to point out it’s one of the most effective forms of birth control out there over the long term with the least side effects barring barrier methods (AKA Condoms). And the periodic follow-up for the IUD is part of your normal gynaecological health and the majority of the follow up consists of checking if the IUD is still in place and can be self done (You just need to see if you can feel for the nylon guide string).

Richard’s Argument is an Argument From Laziness. Don’t get an IUD! You will have to put up some work!

Oh and no doctor will tell you that IUDs stop STDs. They do not. Condoms do. The golden rule is “Women Stop Pregnancy By Using IUDs” and “Men Stop Pregnancy And STDs By Using Condoms”. If you aren’t in a long term relationship and are exclusive then my advice is always always use a  condom.

Want to know something interesting? Even “Magnum” condoms are designed to fit the majority of men. The reason for the failure rate of condoms is poor application because we rarely teach it properly. People don’t read the instructions…

I however DO teach it. Yes, they giggle and smirk but they don’t get pregnant! The condom must be rolled to the base of the penis. The problem with some condoms is the gel used doesn’t feel “right” and causes a loss in rigidity.

My suggestion? Condoms are cheap. Masturbate using one. Get used to it. It’s better in the long run.

But assuming we don’t want to focus on compromising the autonomy and dignity of women to achieve a sterile population, what approaches with wide popular support could reduce abortion, even as it remains legal under the Supreme Court’s decisions?

I fear that the above statement breaches a vital commandment. The one about bearing false witness.

Birth Control is mainly aimed at women because women require it the most since they are the most invested in it’s function. It is high fuckwittery to claim that women are using birth control because of a lack of autonomy when such a statement is made exclusively by an religious organisation famed for it’s denial of women into the upper echleons.

And if one goes back to the case of Savitha who died due to “Catholic” abortion laws we can easily say that the Catholic Church gives no fucks about the dignity of women.

And what ensues is a terrifying perversion of the kind of work I do.

1. Fight poverty. Poverty and the hopelessness it can bring into people’s lives is a major factor in the abortion rate. In one study by the Guttmacher Institute, women on Medicaid had twice the abortion rate of other women, even in states that fund childbirth but not abortions.

I repeat this everytime I handle this topic because people forget it.

When a group of humans eat, we share the food that we have. So if a family can feed four people and there are five then it splits four people’s worth of food into 5 people. Let’s work this out by calorie content.

4 people’s food is roughly 8000 KCal. If there are 5 people there then that’s 1600 Kcal per person. This is a dearth of 400 Kcal per person. This is “malnourishment”. The VAST majority of malnourishment isn’t straight starvation but protein/energy malnourishment where insufficient food and quality of food is available. So if a family of five has enough food for four people then all five people starve.

Okay we are used to families with four people, what about families which can only feed two people or three people. Maybe they cannot afford a one or two kids? An abortion is a lot lot cheaper than a child. I don’t know what they teach in Catholic School these days but children are expensive. They need diapers, food, care, resources, education… That all adds up. If you lack the funds for that then you are screwed. Which is why “poor people have more abortions”. Richard’s statement is just stupid. There are no other words that can describe a man who thinks women abort babies because of the initial cost of childbirth rather than the long term cost of actually raising a child!

In addition? Rich people often have better access to contraceptives and many rich people have better education and so use their contraceptives more effectively.

2. End publicly-funded abortions. That Guttmacher study showed that if the state funds abortions in its Medicaid program, low-income women’s abortion rate doubles Ato be four times that of others.

If you fail to grasp point number 1. then this point makes sense.

This shows how valuable state funded abortion is. Richard thinks that stopping state funded abortion will reduce abortion. It won’t. It will however increase the financial burden of abortion on people.

And if you are so poor that you rely on medicaid abortions then you are probably insecure with your finances and a child is effectively a wrecking ball aimed at your financial house of cards.

3. Pass laws regulating the abortion industry. Research by Michael New and others has shown that even very modest laws — Informed consent, waiting periods, parental involvement for minors, etc. – afford more time to think over an abortion decision and lead to significant reductions.

The Heritage Foundation is possibly one of the few organisations less qualified than the United States Conference of Catholic Bishops to discuss abortion on the sole basis of their front page uses Rush Limbaugh as an advertising feature.

Dear Richard. The entire point of reducing abortion by your method is that your method denies people the choice of whether they want an abortion or not by making it HARDER to get an abortion and lumping people with children whether they want to or not.

  • Informed Consent Laws are a joke. Informed Consent Laws are NOT informed consent. See, informed consent is telling a patient about a procedure. “Mrs Jane Doe? Do you mind a few minutes of your time? I am Avi and I am going to be doing your procedure. You must understand that cataract surgery is a surgical procedure and there are side effects. Now we will try and minimise the risk of these occurring but they sometimes are out of our control. Here are some risks and their relative occurrence. Would you like to undergo the procedure?”. What Richard and his ilk want is “Mrs. Jane Doe? I hear you want Cataract Surgery? Cataract Surgery is linked to these horrid side effects caused by me stabbing your eye. Do you still want it?”. One is informed consent. One is scare mongering by using language to evoke risk.
  • Waiting Periods force women over the border of abortion limits and force them to agonise over an already painful decision. In most cases women ALREADY have to wait a few days for an abortion after deciding to get one.
  • Parental Involvement for Minors is a breach of bodily autonomy and patient-doctor confidentiality since the birth of a child directly affects the girl in question. In addition? Conservative parents can effectively destroy a child’s future by refusing to allow bodily autonomy and force a child to become a mother making further education and indeed career work harder.

4. Uphold strong marriagesUnmarried American women may have four times the abortion rate of those who are married. This factor can combine with poverty in a vicious circle – the disruptions in life caused by poverty can make stable relationships harder to maintain, and unmarried or divorced women lack the personal support system that can help keep them from poverty and a desperate resort to abortion.

Because “Unmarried” women tend to not WANT to have children while married women tend to WANT to have children. In addition married women tend to have better incomes than unmarried (joint incomes are more common here as are healthcare benefits) and so have access to better and more comprehensive contraceptive care.

It’s simple as that. The majority of “Single” women are young and do not want children. None of what Richard said is even remotely sane because it really boils down to a very complicated reasoning instead of a simple one. Single women and men tend to be young. They tend to want to live their lives, concentrate on a career and being secure in their finances before having a child.

It has little to do with single women being poor. This is not the 1820s when a single woman must be married to a man in order to be financial secure! Women have jobs. Women earn money. This has to do with women WANTING TO NOT HAVE KIDS.

And again this piece of literature forgets that even married women do not want to have more kids than they can care for or to have kids when they cannot care for them. It’s just that married women are more likely to want a child because women who marry generally have picked the man who they think they can live their entire lives with and that includes having a family while unmarried women haven’t done such.

5. Promote “sexual risk avoidance” for the young. This is an objective public health term for avoiding sexual involvement, as opposed to the “sexual risk reduction” approach of taking premature sexual activity for granted and then trying to reduce the damage. Recent declines in the abortion rate have occurred disproportionately among teens and young adults, and seem due largely to more young people delaying initiation of sexual activity. Teens are not known for being more reliable in contraceptive use than their elders.

Ah yes! The joke is that we do teach abstinence as part of sex education. Anyone here teach sex education?

How much of sex education is “Respect” and “Body Autonomy” and “Consent”. How much of it is not about having sex but knowing how to respect yourself and your partner? Because that’s important too. That is part of the method of dropping sexual activity at a young age. Because a lot of young sexual activity is just blind frottage committed by hormonal teenagers.

Pointing out that they will feel these urges and that they should respect each other will reduce on the blind drive to fuck because it gives them some meaning as to why they feel this way.

Abstinence only education is like screaming DODGE at soldiers as they charge out onto a battlefield rather than equipping them with body armour.

httpv://www.youtube.com/watch?v=dgyk71VRoUE

Basically? It’s this…

This is an ambitious agenda but most Americans can be shown to support each aspect of it. Those most unlikely to support it are the representatives of “abortion rights” groups, who now speak of abortion being ”safe and legal” (not “safe, legal and rare”) and are even abandoning talk of “choice” in favor of pushing for maximum “access” to abortion. In other words, they don’t want to reduce abortions. But most of us still do.

It’s not ambitious. It’s stupid. It’s a coathanger agenda.

And there is always a CHOICE in abortions. Richard keeps forgetting what choice means. Choice means you can HAVE one if you want to. Not having a choice in abortion means mandatory abortion. China in the 90s was also Anti-Choice despite having legal abortion because they FORCED it on people. Pro-Choice means ease of access of abortion so that you don’t have to struggle to get one. What Richard and his Bishop friends seek to do is reduce choice.

As a medic? Abortion is a vital part of obstetrics and gynaecology.

It’s like suggesting that if we reduce access to orthopaedic surgery people will not break their legs as much.

14 comments

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  1. 1
    throwaway, never proofreads, every post a gamble

    Nothing cogent to add except to share in exasperated frustration at this. And more importantly to thank you.

  2. 2
    Brian E

    So much win in this post as well. :)

  3. 3
    smrnda

    When you mentioned that when you take EC you are already pregnant since the egg is already fertilized – I’m not a doctor but in an embryology class in school (In the US) they treated implantation as the beginning of pregnancy, and so by those standards, EC works after fertilization but before implantation and therefore, before pregnancy has begun. Do they consider fertilization to be the beginning of pregnancy elsewhere? I’m kind of aware that this is an artificial and arbitrary boundary to some degree, just I’m not very knowledgeable on life sciences and took my last bio class a long time ago.

    Great post though with a good take-down of the anti-choice agenda.

  4. 4
    left0ver1under

    Doerflinger’s “arguments” are less semantics than some antics – the antics of a rabidly anti-woman mouthpiece trying to rationalize an untenable position. Doerflinger is the sort of bungler who would criminalize coughing as “solution” to meningitis.

    He’s a licensed physician? A licentious physician is more likely.

  5. 5
    Jason Failes is too lazy to sign in today

    On the mobile site, at least as viewed on this phone, the quotes appear with the exact same font and spacing as what you wrote.
    If it were not for the crazy claims/reasoned response contrast, this would have been very confusing.

  6. 6
    Giliell, professional cynic -Ilk-

    As much as I agree with your article

    Of course they don’t. That’s like suggesting that band-aids reduce injuries. The point of EC is to prevent the implantation of a fertilised egg. You are ALREADY PREGNANT at this stage when you take it, your body hasn’t recognised it yet. It would be categorised as an unwanted pregnancy because if you wanted it you would NOT TAKE THE PILL.

    This is just wrong.
    The currently avaible emergency contraception work by delaying or preventing ovulation. They may have an effect on the uterine lining which would prevent implantation, but there is no strong evidence for that so far.

    Please, this is important, because it is one of the catholic lies told about emergency contraception. Recently, a young woman who had been raped was denied treatment in two catholic hospitals because they said they would have to give her EC as part of the treatment and they couldn’t do that because it would be an abortion.
    By now the catholic bishops have coughed up and admitted that it only stops ovulation and could therefore be graciously allowed to be administered to rape victims (but not to those sluts who just had sex out of their own will)

  7. 7
    Brian E

    Do they consider fertilization to be the beginning of pregnancy elsewhere?

    Yes, the Catholic church does these days. Once upon a time, say 19th century and before, Catholics considered the quickening the moment of ‘ensoulment’, so would have had no issue with abortion in the first trimester….

  8. 8
    Thumper: Who Presents Boxes Which Are Not Opened

    Less well known is the fact that contraceptive programs often fail miserably at reducing unintended pregnancies or abortions — and can be associated with increased rates of sexually transmitted diseases, including AIDS

    I stopped reading at this point. Nothing against you, Avi, I simply am in too good a mood to allow it to be spoiled by the infuriating idiocy which doubtlessly follows this moronic statement. Jeebus but Catholics are idiots.

  9. 9
    Marcus Ranum

    Vasectomies! Lots of vasectomies! Problem solved!

  10. 10
    Hertzey

    I would not suggest reading the comments on the Wall Post. They will make you loose what little faith you had in humanity.

  11. 11
    Hertzey

    *Washington Post.

    My bad

  12. 12
    garnetstar

    “…if the state funds abortions in its Medicaid program, low-income women’s abortion rate rate of safe and legal abortions doubles to be four times that of others.”

  13. 13
    throwaway, never proofreads, every post a gamble

    “…if the state funds abortions in its Medicaid program, low-income women’s abortion rate rate of safe and legal abortions doubles to be four times that of others.”

    That is a really good point, thanks for reminding me of it.

  14. 14
    dandelionc

    Thanks for this article. I wish more people would see not being a parent as a valid choice for women. Sometimes my friends and I joke that there should be roving vasectomy vans and birth control buggies that offer services for free to anyone who wants it because of all of those reasons of reducing poverty and stuff that you wrote about.

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