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Birth control mandate based on ‘cherry-picked’ data: experts

"It is axiomatic - economically and psychologically - that when you dramatically lower the 'risk' or 'cost' of uncommitted sex, you will get more of it," said Helen Alvare.
Mon Oct 3, 2011 - 12:52 pm EST

WASHINGTON, D.C., October 3, 2011 (LifeSiteNews.com) - Proponents of an impending federal mandate to provide birth control drugs for free have not only relied on an ideological presumption that contraception amounts to “preventive” health care, but also on an inaccurate portrayal of birth control’s impact on unintended pregnancy rates, two experts said last week.

In comments released via the Society of Catholic Social Scientists, Professor Helen Alvare, Esq., of George Mason University’s School of Law, and political scientist Michael New of University of Michigan-Dearborn, criticized the data supporting the federal mandate announced by health officials in August.

Mandate proponents “fail completely to account for the fact that, since the federal government began its aggressive campaign to provide free or low cost birth control to millions of Americans in 1970 ... rates of nonmarital births and abortions have grown, not diminished,” said Alvare, who outlined the steady increase of unmarried births each decade since.

Alvare also said that the Institute of Medicine report on which the new mandate is based “cites one lone Guttmacher Institute” study for its claim that contraception availability lowers rates of unintended pregnancy. Guttmacher Institute, the nation’s leading source of statistics on abortion and contraception aside from the federal government, is a former affiliate and current financial beneficiary of Planned Parenthood.

Even so, she said, “newer studies by the very same organization reach a contrary conclusion” on the statistical relationship: a Guttmacher report released this summer found unintended pregnancies falling through the mid-1990s, but holding steady between 1994 and 2001, and apparently increasing since then. The rate notably increased among poor women, the demographic most heavily targeted for state-funded birth control.

These statistics, said Alvare, simply reflect common sense.

“It is axiomatic - economically and psychologically - that when you dramatically lower the ‘risk’ or ‘cost’ of uncommitted sex, you will get more of it,” she said. “Current economic and social literature indicates without a doubt not only that it has happened, but also that it has immiserated women over the course of the last 50 years.”

New, a statistician and frequent critic of Guttmacher, concurred that the Institute of Medicine report’s presumptions don’t hold up under scrutiny.

“As a social scientist, with a Ph.D. in Political Science and a M.S. in Statistics, I have reviewed a considerable amount of research on trends in births, pregnancies, and abortions,” said New. “I have yet to come across one peer reviewed study which shows that increases in public funding for contraceptives or mandates of contraceptive coverage in insurance policies lowers either abortion rates or the rate of unintended pregnancies.”

Meanwhile, he said, there is little to suggest that there is a shortage of birth control in the United States: he cited a 2009 study of 76 low-income couples in Chicago and New York who, after they had given birth, were asked whether they had been in a situation where they needed contraception but were unable to afford it.

“Tellingly, all said no,” said New. “In fact, according to [researchers] Eden and England, ‘some laughed when we asked this question, pointing out how hard clinics and school in their communities push contraceptives.’”

The two professors’ full comments are below.


Helen Alvare:

The proponents of the current regulations mandating health insurance providers to offer birth control and abortifacient drugs and devices without co-pays claim (on the basis of “cherry-picked” research) that it will lead to improved health for women and children, i.e. that it will reduce unintended pregnancies and abortion. They fail completely to account for the fact that, since the federal government began its aggressive campaign to provide free or low cost birth control to millions of Americans in 1970 (with the “National Family Planning Program,” known as Title X of the Public Health Service Act [1]), rates of nonmarital births and abortions have grown, not diminished.

Respecting nonmarital births, for example, in 1970 the rate of unmarried births per 1000 women of childbearing age was 26; in 1980 it was 29; in 1990 it was 44; in 2005 47; and in 2008, 52.5 [2]. The Department of Health and Human Services [3] summarized the data between 1960 and 2000 as follows: “Nonmarital childbearing increased among women of all age groups between 1960 and 1994 before dropping off modestly in 1995. … However data for 1996 through 1999 show continued increases for women age 15 through 19, 20 through 24, and 25 through 30.” The report continued: “Nonmarital births as a percent of all births have increased among teens of all ages and across all racial and ethnic groups since 1960. … and among women of all ages.” The report showed that nonmarital births as a percentage of all births were 5.3 % in 1960, 11 % in 1970, 18% in 1980, 28% in 1990, and 33% in 1999 [4]. Today, nonmarital births are at an all time historic high of 41% [5]. In fact, they are 35% higher than 1980 and 75% more than 1970, when federal funding first began under the Title X program [6].These rates persist while birth control availability has expanded exponentially among women of reproductive age. According to the Centers for Disease Control, for example, as of 2004 [7] 89% of sexually active women of reproductive age “at risk” of becoming pregnant use contraception, and 98% have used it in their life time.

Regarding “unintended pregnancy,” a leading focus of the Institute of Medicine Report on which the new mandate is based [8], while the report cites one lone Guttmacher Institute (a former Planned Parenthood affiliate) study for its claim that greater availability of contraception lowers rates of unintended pregnancy, newer studies by the very same organization reach a contrary conclusion. A June 2011 Guttmacher report notes rather that while the rate of unintended pregnancies fell through the mid-1990s, it remained steady between 1994 and 2001 and appears to have increased since 2001.

Of particular note, the rate among poor women has been increasing since the mid-1990s [9].  Such women are the subject of the most intensive federal and state spending for birth control. Contraception is the only service for which the federal government reimburses the states at the rate of 90%. A closer look at various state programs indicates further that contraceptives are ultimately provided free to poor women in many cases by means of a further state subsidy [10].

Finally, the federal choice to continue to pursue this policy, in the teeth of its empirical failure, and even to the point of trampling religious freedom, is a blow to the cause of women’s freedom. It would have been shocking had the “birth control solution” to the phenomenon of uncommitted sex had not altered the sex and marriage markets drastically. It is axiomatic—economically and psychologically—that when you dramatically lower the “risk” or “cost” of uncommitted sex, you will get more of it. Current economic and social literature indicates without a doubt not only that it has happened, but also that it has immiserated women over the course of the last 50 years [11]. Women are far more likely today—in the presence of the message that “sex is the price of even short term heterosexual relationships”—to bear a disproportionate share of the burdens associated with uncommitted sexual encounters: depression, sexually transmitted diseases, crisis pregnancy, abortion and single motherhood. This new federal policy only exacerbates what is already a hostile sexual environment for women.

[1] Title X Family Planning Program [“Population Research and Voluntary Family Planning Programs”] Public Law 91-572 (1970).

[2] Joyce A. Martin, et al, births: Final Data for 2008, National vital Statistics Reports (Vol. 59, no 1), December 2010.

[3] Babette Gutmann & Jennifer Hamilton (Westat), Trends in the Well-Being of America’s Children and Youth 2000, U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (2000).

[4] Ibid.,  at Table PF1.7.A.

[5] Brady E. Hamilton, et al, Births: Preliminary Data for 2009, National Vital Statistics Reports, Vol. 59, No. 3 (Dec. 21, 2010) at http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_03.pdf.

[6] See Child Trends, Facts at a Glance, A Fact Sheet Reporting national State and City Trends in Teen Childbearing, April 2011, Pub. #2011-10 at http://www.childtrends.org/Files/Child_Trends-2011_04_14_FG_2011.pdf .

[7]  Centers for Disease Control and Prevention, Advance Data No. 350, Dec 10, 2004: Use of Contraception and Use of Family Planning Services in the United States : 1998-2002.

[8] See Clinical Preventive Services for Women: Closing the Gaps, p. 92.

[9] Guttmacher Institute, Unintended Pregnancy Rates at the State Level, at http://www.guttmacher.org/pubs/psrh/full/4307811.pdf).

[10] See, e.g. Wisconsin Dept. of Health and Human Services, Family Planning and Clinic Services: Information for Providers (2002), 11 at https://www.forwardhealth.wi.gov/kw/pdf/family_planning.pdf (“Providers are not permitted to charge copayments for family planning services”); Minnesota Department of Human Services, Medical Assistance Coverage, at http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&dDocName=id_006921&RevisionSelectionMethod=LatestReleased (“Services that MA pays for: family planning services”).

[11]  See, e.g. George A. Akerlof, Janet L. Yellen and Michael L. Katz, An Analysis of Out-of-Wedlock Childbearing in the United States, 111 The Quarterly Journal of Economics 277 (1996); and Mark Regnerus & Jeremy Uecker, Premarital Sex in America (2011); and Roy F. Baumeister, Kathleen D. Vohs, Sexual Economics: Sex as Female Resource for Social Exchange in Heterosexual Interactions, 8 Personality and Social Psychology Review 339 (2004).


Michael New:

As a social scientist, with a Ph.D. in Political Science and a M.S. in Statistics, I have reviewed a considerable amount of research on trends in births, pregnancies, and abortions. I have yet to come across one peer reviewed study which shows that increases in public funding for contraceptives or mandates of contraceptive coverage in insurance policies lowers either abortion rates or the rate of unintended pregnancies.

Conversely, there is plenty of research which shows that contraception is widely available.  About 10 years ago the Guttmacher Institute did a comprehensive study of women who had abortions [1]. Of those not using contraception, only 12 percent said that they lacked access to contraceptives due to financial or other reasons. Additionally, in the book Unmarried Couples with Children, sociologists Kathryn Edin of Harvard and Paula England of Stanford conducted an intense study of 76 low-income couples from Milwaukee, Chicago, and New York who had just given birth. Edin and England found that only a very small percentage of these women wanted contraception, but were unable to afford it. Some of these couples were married, but most were not. The fertility patterns of all of the women in the survey were carefully studied for 4 years [2]. Edin and England found that only a very small percentage of these women wanted contraception, but were unable to afford it [3]. Specifically, all of the women surveyed were asked whether they had been in a situation where they wanted birth control, but could not afford or find it. Tellingly, all said no [4]. In fact, according to Eden and England “some laughed when we asked this question, pointing out how hard clinics and school in their communities push contraceptives”[5].

[1] Jones, Rachel, Jacqueline Darroch, and Stanley K. Henshaw.  2002.  “Contraceptive Use Among U.S. Women Having Abortions in 2000-2001” Perspectives on Sexual and Reproductive Health 34(6): 294-303.

[2] Edin, Kathryn and Paula England. 2009. Unmarried Couples with Children. Russell Sage Foundation. New York. pp 5-6.

[3] Ibid., p. 32.

[4] Ibid., p. 48.

[5] Ibid.


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