The Right's Bitter Pill

Carole Joffe

May 05, 2005

“Contraceptive use in the United States  is virtually universal among women of reproductive age: 98% of all women who have ever had intercourse had used at least one contraceptive method...82% had ever used the oral contraceptive pill.” 
  
The above quote, from a recent CDC report on the use of contraception in the United States, points to the futility of current campaigns in this country to limit women’s access to contraception. Birth control is not only widely used, it is strongly supported by Americans.  (Some 80 percent, in a recent poll, believed that contraception should be covered by all health insurance plans.) This does not bode well for the prospects of one of the most unusual new fronts in the never-ending abortion war in this country—the growing instances of "pro-life" pharmacists who refuse to fill prescriptions for oral contraceptives—a.k.a. the pill.

Beyond the implications for the abortion issue, the pill scandal also sheds light on the growing miscalculations of the religious right.  In a classic pattern of the hubris that often follows an electoral victory, this movement has recently been “overreaching” in a number of areas. The massive mishandling of the Schiavo case and the concerted campaign to allege religious bias in the issue of judicial selection—which even President Bush repudiated in his recent press conference—are only two examples.  But interfering with access to the pill, used by millions of women across the political spectrum, could be key to making the American public wake up to the threat these religious zealots pose to aspects of everyday life we take for granted.

We actually do not know how many instances of such refusals there have been. Nor is this an entirely new phenomenon. Some pharmacists have long refused to fill prescriptions for emergency contraception (EC), a drug that, if used within 72 hours of unprotected intercourse, can prevent a pregnancy.  (The Wal-Mart chain of pharmacies had a long-standing policy of not carrying EC). What is known is that, in some of these recent cases, the pharmacists involved have refused to fill ordinary birth-control pill prescriptions for married women as well as single women. In some cases, women are referred to another drugstore, though not always; in others, they are subjected to a lecture by the pharmacist on their immoral behavior, as evidenced by use of the pill.

Thanks to cable television, these incidents have received intense publicity. And they have spurred a variety of legislative efforts—some focusing more on the rights of pharmacists to refuse to fill prescriptions on “conscience” grounds, others focusing more on the rights of women to have access to legally available medications.

Ironies abound in this attack on oral contraception. The history of the pill in the United States is a saga of shifting political alliances. The pill came into use in this country in the early 1960s, just a few years before the Supreme Court affirmed the legality of birth control for married persons in the famed Griswold v. Connecticut case in 1965. A few years later, during the presidency of Richard Nixon, Congress established the first federally funded program to offer family planning services to poor women: Title X of the Public Health Act. The pill became widely prescribed at Title X-supported centers.

Moderate Republicans were among the key promoters of this legislation, including a congressman from Texas, George H.W. Bush (whose alleged nickname at the time was “Rubbers,” because of his enthusiasm for condoms).  Meanwhile, some  feminist health activists—while not opposed to government involvement in birth control—were highly skeptical about oral contraception, claiming the safety of the pills was unproven and they that contained too high a hormonal level. 

With the coming of the New Right (the precursor to today’s religious right) and the election of Ronald Reagan in 1980, the politics of contraception abruptly changed.  The old consensus on contraception among moderates of both parties—that contraception deserved support because it prevented abortion—broke down.  At that point, religious conservatives—a number of whom were members of Congress—began to vilify most forms of contraception as “supportive of the abortion mentality.” 

This argument was made, first, on the basis of where contraception was obtained by many women, especially teenagers—often in the same Planned Parenthood clinics and freestanding women’s health centers that began to offer abortion after the 1973 Roe v. Wade decision.  But attacks on birth control also stemmed from a novel definition of pregnancy originating in the most orthodox wing of the anti-abortion movement.  Standard medical usage defines a pregnancy as commencing with implantation of a fertilized egg into the uterine wall; for the religious riight, pregnancy begins with the fertilization of an egg—thus rendering most forms of contraception (whose mechanisms are not entirely understood) as possible “abortafacients," because they may interfere with implantation.  

Women’s health activists, on the other hand, are today far more comfortable with oral contraception. Responding to earlier criticism, pharmaceutical companies began producing pills with much lower hormonal dosages.  Moreover, research has shown that women using certain forms of these pills have lower rates of ovarian and uterine cancers than those women using other contraceptive methods.

The surreal situation then, at the 40th anniversary of the Griswold decision, is that a potent force in American politics wishes to deny women basic contraception.  Such egregious policies give the embattled reproductive freedom movement an excellent political opportunity to expose the hypocrisy of the contemporary anti-abortion movement. As is becoming clearer and clearer, the reproductive freedom movement—while believing in legal abortion—works to prevent unwanted pregnancy. The anti-abortion movement—while opposing abortion—promotes anti-contraceptive policies that virtually assure there will be more unwanted pregnancies and therefore, more abortions. 

A friend of mine who runs a women’s health center, which offers both abortions and family planning services, tells me that picketers—ostensibly there to protest abortion—scream about “weapons of mass destruction in the womb” when birth control supplies are delivered to her clinic.  She also points out that she and her colleagues on the front lines of reproductive health delivery have “for years been saying that these people are against birth control too...but nobody listened to us.”  Hopefully now, the 98 percent of American women cited in the CDC report will.