choice

Two Interesting Notes About IUDs: As Emergency Contraception, As Politically Rather Than Medically Contraindicated

Sungold of Kittywampus has some interesting, and cool, news about new uses for IUDs

Actually, this isn’t a truly new option, just one that has gotten no press up to now: using an IUD for emergency birth control:

“A copper intrauterine device was 100 percent effective at emergency contraception in a study of almost 2000 Chinese women who had the device implanted up to 5 days after unprotected sex.”

Read the rest of her post, and follow the links, here.

Sungold adds that she thinks IUDs would be…

Especially for anyone who’s a repeat customer for EC, the IUD seems like a highly sensible choice. While IUD insertion can cause cramping (which can persist for a few days), Plan B can inflict pretty intense nausea. Having to chase down EC repeatedly is stressful for body and soul. Where 1 in 100 women will still get pregnant on Plan B, it’s fewer than 1 in 1000 with the IUD as EC. And in the long run, a woman who chooses the IUD is highly unlikely to face an unwanted pregnancy.

That’s not a panacea. But it’s a pretty excellent option.

I think that’s about right. But then of course I’ve always been a big fan of post-Dalkon-Shield-debacle IUDs, going back to the original low-impact copper Ts of the 1970s. But then there’s the bit about how healthcare providers remain reluctant to provide IUDs… even caregivers who use and swear by them personally. And since I’ve got a vasectomy I’m not exactly a candidate for IUDs, and so my enthusiasm has always been muted with a great deal of deference.

Which is why I was happy to see Sungold’s update based on comments on her post by MomTFH. MomTFH said

According to a midwife who taught me about birth control, the reason why IUDs were not recommended for women [who haven’t been pregnant] were because so many of them successfully sued over the Dalkon shield. The company had to pay a much higher settlement to women who never got to have children due to their injuries than they did to those who already had children. The indications for the newer IUDs, including the copper T, originally said the ideal candidates were parous women, but that is no longer the case. New recommendations say that pretty much any woman who does not have active pelvic inflammatory disease is a good candidate.

The Dalkon shield was a completely untested, unresearched, unregulated piece of scrap metal. The copper IUD is a much more carefully created and substantiated device. It has a higher rate of continuance of use than any other form of birth control. Not only do I have an IUD, but the IUD is an incredibly popular form of birth control among female ob/gyns I have very unscientifically surveyed.

That makes a little more sense. Not in the conspiracy-theory sense, just in the practical institutional-memory-informs-practice sense. With the benefit that institutional memory will shift as people in the medical industry, like MomTFH, begin speaking out.

Final note: I’m not sure anti-choice wingnuts are going to be cheery about IUDs as emergency contraception. But then again they already oppose IUDs anyway. So… cry wolf much?

For Crying Out Loud! "Common Ground" Is About Recruiting the Moderate Majority, Not Compromising With Hard-Core Anti-Choicers

Scott Lemieux of TAPPED is logically correct but, I think, tactically mistaken for dismissing pro-choice efforts to look for “common ground” with anti-abortion conservatives.

To follow up on Monica’s post about Dana Goldstein’s terrific article about the coming battle over contraception, it’s also important to emphasize what Republican opposition to contraception reveals about cultural conservatism.

...

The problem with this line of reasoning is that it ignores the broader set of assumptions about women and sexuality on which actual opposition to abortion is based. Consider anti-choice Republicans, who consistently opposed expanding contraceptive use: Given the choice between reducing abortion rates and controlling female sexuality, they will always choose the latter. Thus the idea that contraception can be a means of achieving a ceasefire in the culture wars has always been a fantasy. Liberals and conservatives aren’t just divided by abortion but by broader questions of female equality and sexual freedom.

He said it here.

I agree strongly that there’s a hard core of social conservatives who just flat-out hate the idea of women having sex (or possibly instead hate the idea of men having sex with women) and “getting away with it.”

And for those people abortion is virtually a red herring, relevant only to the extent that abortion, like contraception, amounts to a get out of jail card on the “wages of sin.”

Fine. You’ll never reach compromise with those people.

The trick, though, is that the hard core hides behind a heck of a lot of people who are squishy on abortion, sometimes really squishy, but 100% fine with contraception.

Those people you can find common ground with. And for logical and tactical reasons it’s extremely important to do so.

The point of engaging in “common ground” rhetoric isn’t about getting to compromise with the acid right. It’s to flush them out, to drive a wedge, to starkly separate them from their nominal allies in the squishy middle.

Maybe 20 years ago someone from Operation Rescue very bluntly said it was their policy to oppose initiatives that only reduced abortions because, in his opinion, unless abortions continued in big, big numbers the majority of opponents would lose interest in the issue.

“Common ground” solutions like contraception availability amounts to calling their bluff.

Would it be great if the majority of people were willing to back abortion rights 100%? Oh yeah, definitely. But the bad guys wish the majority were as enthusiastic about letting women die of preventable pregnancy-related complications. Since neither side seems likely to get such support, it becomes a question of who can provide intermediate solutions that are most appealing to the majority in the middle.

I happen to think the most appealing intermediate, a.k.a. “middle ground” solution is pressing hard on contraception. First of all because all but the fanatics are comfortable with it, and second because while nearly all the squishy middle are squishy about the boogeyman of “abortion on demand” they’re actually extraordinarily tolerant of abortion as a backup when contraception fails. That’s exactly Terry Randall and the American Bishop’s worst nightmare and… I just can’t see any reason why we shouldn’t give it to them.

So. Bottom line: you can’t compromise with fanatics, but by appearing reasonable (heck, by being reasonable!) you can peel off millions and millions of their nominal supporters.

I say go for it.

What Are You Going to Do to Protect Affordable Care Act Contraceptive Coverage From Wingnut Attacks?

Matthew Yglesias comments on the good news about contraceptive access provisions in the Affordable Care act and the possible bad news in Dana Goldstein’s report that anti-choice activists are gearing up to keep those provisions from taking effect.

Politically speaking, I think this is the fight progressives have been wanting to have for some time now—something that would highlight the deeply reactionary and anti-woman ideology that drives the main institutional players in the anti-abortion movement. But will it be possible to get people to pay attention? These non-abortion reproductive health aspects of the Affordable Care Act got very little attention from either side.

He said it here.

That it wasn’t well-known is probably good news overall. Had it been then the anti’s noise machine could have put the brakes on it. Instead they were content to rattle on about other sticks-to-the-wall shit they were throwing.

But if it’s unknown there’s now a risk that the ‘wingers could get their hooks in it first, leaving progressives to play catch up yet again, still, as always.

So much the better then that Goldstein’s raised the concern and that Monica Potts, and Yglesias, Lindsay Beyerstein, Kevin Drum, and me, and (hint, hint) you and (HINT! HINT! HINT!) major-fundraising national-powerhouse feminist and progressive institutions start working the issue first.

Jessi Fischer on Feminism, Condoms, and Choice

Jessi Fischer of The Sexademic, who’s just received her masters degree in sexuality from San Francisco State University says

This blog has seen its fair share of feminist bashers, quoting Valerie Solanas and Andrea Dworkin as if they represent a synthesized doctrine of Feminism. But those fools have it all wrong. In all the gender studies and women’s studies courses I took I never once read those women.

You want classic feminist theorists? Try Mary Wollenstonecraft. Try Virginia Woolf. Try Charlotte Perkins Gilman. Try Sojourner Truth. Try Simone de Beauvoir. Fuck, how about John Stuart Mill, Frederick Douglass or Henrick Ibsen? How about our modern feminists like Betty Friedan, Gloria Steinem or Susan Faludi?

Feminism is not about man-bashing, porn-censure or making sure every woman works outside the home.

Feminism is about choice.

And because we are individuals with vastly differing opinions, feminist theorists contradict each other and argue with each other. There is no unifying feminist doctrine except choice.

She said it here.

That sounds about right. There are a lot of ideas about what feminism is all about. And even more ideas about how best to express feminism. And yeah, some of them can be as bitterly and sometimes even violently in conflict as any other broad social and political philosophies as broad as Christology to as (seemingly) obscure as taxonomy.

The other major element in her post is a pean to condoms, which she introduces with…

I know what you’re thinking. Condoms? Yes. My contraceptive method of choice allowed me to take control of reproduction and, consequently, my life.

I try to imagine worlds where sex with a man often leads to pregnancy. Or worlds without protection against STIs. The freedom to learn and develop my mind could be hindered by childrearing or health complications.

If you had a very narrow or, particularly, a very conservative notion of feminism (where “conservative” refers both to the right-wing conservatism of, say, Nikki Haley or the separatist conservatism of Mary Daly) you’d might raise an eyebrow, at least, at the idea of sex with men, let alone sex with men using the iconically “male” condom as contraception. Eh. Maybe so. Some schools of feminism really do balk at the idea of contraception (Haley) or men (Daly) let alone using contraception while having sex with men. But just as it would be a mistake to confuse their thin-ice edges with the more-literally-central ideas it would be an even bigger one to pick either one of those arguably doctrinally choice-limiting extreme cases and decide it represented the whole.

Difference Between "Pro-Choice" and "Pro-Abortion" #37,646

While discussing the… problematic issue of an alt-religious cult insisting that certain of its members have abortions Jos of Feministing illustrates the difference between being “pro-abortion” and being pro-choice.

Abortion should always be an available option, but how someone acts on their own pregnancy must be their decision. To coerce someone to have an abortion, to take away that decision, is the very definition of anti-choice.

She said it here.

When you’re pro-choice it’s all about supporting choice! If one was merely pro-abortion one would be indifferent when someone’s decision to continue her pregnancy isn’t respected.

Abortion services really should always be an available option because not everyone wishes to remain pregnant, nor is everyone medically able to safely remain pregnant. But that’s just one part of being pro-choice.

Anti-Choicers Want Us to See Fewer Abortions As a Win, Let's Focus On Fewer Unplanned, Unwanted Pregnancies Instead

Summary: The way “reducing abortions” is almost always framed distracts us from the more legitimate, and legitimately pro-choice issue of reducing the number of unplanned, unwanted pregnancies. Here’s what we should be doing instead. And why. And why.

Silvana Naguib, who’s now blogging at TAPPED says…

Ever since President Bill Clinton introduced his succinct position on abortion: “safe, legal, and rare,” the goal of reducing the number of abortions has been a stated aim of abortion rights as well as anti-abortion groups. Last year, then-presidential candidate Barack Obama promised the pope that he would make efforts to reduce the number of abortions in the United States.

But should decreasing abortion rates be a stated goal of the reproductive-justice movement? Aimée Thorne-Thomsen says no. She makes the case that we should instead focus on increasing all options for women, expanding their liberty to make the right choice for them.

She said it here.

I say no too, for basically the same reasons. Framing the issue in terms of numbers of abortions avoided is going about it completely backwards.

Back before Roe was handed down our argument was that abortion was necessary as a fallback for contraceptive failure and/or failure of personal autonomy and/or failure to use contraception due to lack of education, access, affordability, safety, or usability of contraception.

And the reason we framed it that way back then is that we knew that even when it became legal, is that abortion is more expensive, more time-consuming, more uncomfortable, and medically more risky than any other method of avoiding unplanned, unwanted pregnancies.

Point being that making abortion “rare” should only be a highly-desirable outcome of making unwanted, unplanned pregancies rare.

And the obvious way to get there has no, zero, none relationship to restrictions on abortion. Instead it has everything to do with making a variety of contraception options safe, legal, available, reliable, usable, and affordable for women and men. It has everything to do with comprehensive sex education that includes not just “birds and bees” biology, anatomy, and technique but also appropriate modeling of negotiation and respect for decision-makers not just regarding sex but regarding relationships as well. Heck, for extra credit you can even toss abstinence advocacy on top of all that.

And the result of those policies (ok, except maybe the abstinence part) really would make abortion rare. But as a result, not a goal.

Of course no matter how well all of the above might work there will still always be a need for the fundamental right to fall back on abortion. So no matter how rare it becomes abortion will always need to be safe and legal and there.

—-

Can I just add one more thing about reframing the question away from abortion (where secular and lay opponents work hard to keep it) and towards preventing unplanned, unwanted pregnancy (where they really, really don’t want to go?)

When the issue is framed in terms of abortion then an increase in the raw numbers is considered a “failure” and a decrease is considered “success.” That’s great for Popes and the rest of the nopes, so you can see why they love that way of looking at it.

If instead you start looking at it in terms of education, autonomy, and in terms of safe, affordable, available, useable, and reliable birth control then an increase in the number of unplanned, unwanted pregnancies becomes the point of failure and a corresponding decrease becomes success. And an increase or decrease in abortion becomes a sideshow.

Popes and other nopes prefer to keep the focus on abortion rather than unplanned, unwanted pregnancies because with the former they can pretend they’re part of the solution. With the latter there’s no way they can pretend they’re not part of the problem.

Right-Wing Anti-Choice Groups Featherbedding On the Government Dime? Who Would Ever Suggest Such a Thing?

Given my family’s personal experiences with “crisis pregnancy” centers I have just about zero patience with this sort of crap, so check out the dirt Jessica Valenti of Feministing has dug up in Virginia.

I’m just shocked that Heartbeat International – the organization that gets the majority of money made from Virginia’s “Choose Life” license plates – is possibly misusing funds. The anti-choice organizations gets $15 from the $25 plates, and distributes the money to crisis pregnancy centers. Or just random anti-choice buddies, it’s become kinda unclear.

One pregnancy center listed by several anti-abortion groups as a certified clinic — the Mattingly Test Center in Loudoun County — is a two-story brick house owned by Linda Mattingly, a former director at Care Net, a Leesburg-based pregnancy network. There are no signs in front indicating it is a clinic, the Internal Revenue Service has no record of it as a 503© nonprofit, and it is not registered as a corporation with the Virginia secretary of state.
A woman who answered the door of the Ashburn house last week said pregnancy services had been, but no longer were, provided there. She did not give her name before closing the door. The Washington Post tried to reach Mattingly by phone, but messages were not returned.

...

The report [from NARAL Pro-Choice Virginia] also outlines the standard bullshit that crisis pregnancy centers peddle in: false medical information, non-medically trained staff, and scare tactics like telling women they could become a “crack whore in prison” if they get an abortion.

Read the quote in context here.

I think I’ve said this before in the context of abstinence-only “education” but it sort of stands to reason that organizations that know bloody well they’re providing no honest, legitimate, meaningful pregnancy crisis services would tend not to take their “responsibility” to provide those non-services very seriously.

Especially since anyone inside the anti-choice noise machine who demanded accountability for funds received from automatic government funding would just be inviting scrutiny of any non-services they themselves might be getting paid to provide.

January 22: It's Blog for Choice Day - Enjoy It While You Still Can

I almost never get it together to participate in really important “meme” days of remembrance, or even days of celebration, on the actual designated day.

Today is Blog for Choice DayIf I hadn’t stumbled across it at Scarleteen I’d have missed remembering today is Blog for Choice Day. And by the time I’d figured it out (sometime over the weekend) I’d feel dumb for having missed it and not say anything at all.

Most years I’d just say “every day ought to be blog for choice day anyway” and be done with it. This year, though, the new Republican-activist majority on the Supreme Court has handed down it’s… fascinating decision that, say, the entire Walmart Corporation has the same just-folks right to pay as much as it wants immediately before an election as any supporter of a small-town zoning-board candidate. Which suggests they might as easily next use identical logic rule that abortion restrictions are just as they infringe on pregnant men’s rights no less than pregnant women’s.

In these days of disappointment it’s so tempting to think of just staying home next time there’s an election… as, for instance, millions chose to stay home in 2000, 2004 when it might have made a difference who replaced Justices Reinquest and O’Connor.

It’s your choice to do so again in 2010.

Enjoy it while you can.

Happy Blog for Choice day.

Matt Yglesias on Mistaken Thinking About Preventable Deaths

Matthew Yglesias thinks instructively about why people imagine some kinds of preventable deaths are more important than others.

It’s quite true that human beings do not have a great intuitive grasp of statistical arguments or a great love for them. But the world would be a better place if people thought of these things in a more statistically informed way. Likewise it’s true as Jon Chait says that people generally think differently about intentional murders than thinks like car crashes. But this, though it’s definitely a fact of life, is also a problem that it would be good to ameliorate over the long run. People tend to view threats stemming from identifiable, individual villains as more problematic than impersonal ones. But while this is a fact of life, it’s also a mistake. If we do something to very slightly reduce the risk of a terrorist attack that has the inadvertent consequence of causing a large number of additional highway deaths then that would be a mistake.

Read the quote in context here.

I’m… fairly confident many of the same principle applies to matters of sex, choice, reproduction and contraception, agency and autonomy, etc. Opposition to hormonal contraception, for instance, not because of the small but real risk of embolism or thrombosis in the woman who takes it but instead an infinitesimal-to-the-point-of-imagination risk that ovulation and fertilization of a hypothetical “life” might somehow magically occur… and yet somehow not implant. To name one. To name another, fanatic willingness to murder healthcare providers in church over abortion but absolute zero, nothing, none interest, at all, in parting a hair to prevent about approximately equal numbers of miscarriages (environmental- or stress-induced or otherwise)... or to do anything at all about stillbirths, infant or maternal mortality, or prevention of childhood deaths from, say, asthma.

But again it’s a general principle. Although expand the scope just a teeny tiny bit and you’re left wondering about the “moral” hesitation in the early 1980s that allowed HIV to become a global epidemic instead of a relatively isolated outbreak, where squeamishness about thousands of “h-word” people (hemophiliacs, heroine users, and homosexuals) mainly in the U.S. allowed it to spread to tens of millions of “pa-word” people (pretty-much anybody.)

Stupak, Stereotypes, and "Those People"

Amanda Marcotte of Pandagon says

...even though most people, when pressed, don’t have the nerve to force women to have babies against their will, anti-choicers aren’t entirely wrong about their ability to use female sexuality to stir up anger and fear.  The problem is that when you get people to think about this logically, they’re pro-choice.  But when you appeal to them emotionally, they’re all too easily sucked into hating on sluts, believing female sexuality is dangerous, and wanting it to be controlled.  When asked specifics about how it should be controlled, people balk—-they want it to be controlled, but they don’t want there to be actual force involved, in part because most Americans have female sexuality as part of their own sex lives, and they don’t want their own bedrooms invaded.  The key to creating a sex panic is making the panickers believe this is about Other Women.  And unfortunately, 65 Democrats are convinced that this amendment is about punishing Other Women, not their own voters.

She said it here.

Elsewhere in her post Amanda links to an interesting article from 2000 called “The Only Moral Abortion is My Abortion” When the Anti-Choice Choose. In my own conversations with women’s and family-services professionals it turns out that “good” women seeking “moral” abortions are a healthy proportion of the clientele.

Funny thing, though, is this notion of, I guess, “immoral” abortion isn’t exclusive to ‘wingers. The other day I was grousing about the Stupak debacle to an educated, progressive-to-radical woman and her angry reaction was “well, does he just think a good alternative is more of these twenty-four year old girls having six different children by six different fathers instead?!?!”

Can I just say how frustrating that is?

For the record, though, about six in ten women who have abortions already have one or more children. Roughly a third are married and a quarter of those who are unmarried live with a male partner, which my very poor arithmetic says that adds up to 49.7 percent. Stereotypes about “godliness” are not — 78% say they’re religious. The fact that 88% live in metropolitan areas would be a stereotype-affirming gotcha… if not for the fact that 79% of everybody lives in metropolitan areas. The stereotypes about income do hold up — 57% are economically disadvantaged. (But even there, not to put too fine a point on it, but back in the days before Roe vs. Wade we noticed that the daughters of upper-middle-class families had a disproportionately high rate of “appendicitis.”)

I mean, yeah, I guess, even though it’s more a production of racist/classist/conservative fantasy than reality there are women who match the stereotype of multiple pregnancies by multiple partners. But in absolute terms it would be about as accurate… if also just as much a caricature… to say the stereotypical abortion seeker is a lower-middle-class midwestern married or long-term partnered suburbanite who doesn’t see herself as one of “those people” at all.

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