A contraception dilemma

For more than 19 million American women of childbearing age, the revelation last week that the U.S. Supreme Court’s conservative majority may soon rescind the constitutional right to an abortion was no doubt doubly alarming.

That’s the estimated number of women who live in “contraceptive deserts” — counties without convenient access to a health center that offers the full range of contraceptive methods — according to new data from Power to Decide, a nonprofit that advocates for reproductive freedom, and George Washington University.

The frustrating and unacceptable message to them is this: Don’t get pregnant, and good luck finding effective means to avoid it.

This was already a bad situation for so many women, including an estimated 1.2 million in New York. Even in a state that requires public and private health insurers to cover contraception, it’s a challenge to obtain for close to one in nine women.

The situation appears likely to grow more dire, especially in states in the middle of the country that are poised to make abortion illegal if and when the Supreme Court strikes down Roe v. Wade and Planned Parenthood v. Casey. For nearly 50 years, Roe and subsequent decisions like Casey have recognized women’s constitutional right to choose whether to have an abortion, and limited the ability of states to restrict it. A draft ruling leaked last week would leave it to states to regulate and even ban abortion.

While the vast majority of Americans support some degree of abortion rights — 80 percent, according to a Gallup poll, and even more in cases of rape, incest, or if the woman’s life is in danger — upward of 26 Republican-dominated state legislatures stand ready to impose bans or severe restrictions. And there is some fear that with the ruling dealing a blow to the underlying assumption of a constitutional right to privacy, conservatives may intrude into other areas of human sexuality and relations, including contraception.

This should concern people on all sides of the abortion issue. If you don’t want women to have unwanted pregnancies, they must have access to effective birth control. Expecting people to abstain from sex is to deny drives at the very root of our endurance as a species. And they need access to a full range of options, not just condoms and other over-the-counter products, or “fertility awareness” methods whose effectiveness is as low as 76 percent, compared with more than 90 percent for oral contraceptives and better than 99 percent for IUDs.

It’s important to remember that even if the Supreme Court’s conservative majority guts abortion rights — a ruling is expected this summer – abortion won’t go away. It will be still be legal in roughly half the states, and it will likely go underground in states that would make the procedure a crime, with all the dangers that entailed before Roe allowed abortion to be properly treated as part of women’s health care.

If those who call themselves pro-life truly want to stop abortions, they should support effective programs to prevent unwanted pregnancies — factbased education about human sexuality in schools, and affordable, widely available contraception and reproductive health care — that would be even more essential in a post-Roe America than they are today.