Plan B Forum

All of the new Oklahoma laws aimed at limiting abortion and contraception are great for the Republican family that lives in a gingerbread house with a two-car garage, two planned kids and a dog. In the real world, they are less than perfect.

As a practicing physician (who never has or will perform an abortion), I deal with the real world. In the real world, 15- and 16-year-olds get pregnant (sadly, 12-, 13- and 14-year-olds do also). In the real world, 62 percent of women ages 20 to 24 who give birth are unmarried. And in the world I work and live in, an unplanned pregnancy can throw up a real roadblock on a woman's path to escaping the shackles of poverty.

Yet I cannot convince my Republican colleagues that one of the best ways to eliminate abortions is to ensure access to contraception. A recent attempt by my fellow lawmakers to prevent Medicaid dollars from covering the “morning after” pill is a case in point. Denying access to this important contraceptive is a sure way to increase legal and back-alley abortions. Moreover, such a law would discriminate against low-income women who depend on Medicaid for their health care.

But wait, some lawmakers want to go even further and limit everyone's access to birth control by allowing pharmacists to refuse to fill prescriptions for contraception.

What happened to the Republican Party that I joined? The party where conservative presidential candidate Barry Goldwater felt women should have the right to control their own destiny? The party where President Ronald Reagan said a poor person showing up in the emergency room deserved needed treatment regardless of ability to pay? What happened to the Republican Party that felt government should not overregulate people until (as we say in Oklahoma) “you have walked a mile in their moccasins”?

Is my thinking too clouded by my experiences in the real world? Experiences like having a preacher, in the privacy of an exam room say, “Doc, you have heard me preach against abortion but now my 15-year-old daughter is pregnant, where can I send her?” Or maybe it was that 17-year-old foreign exchange student who said, “I really made a mistake last night. Can you prescribe a morning-after pill for me? If I return to my home country pregnant, life as I know it will be over.”

What happened to the Republican Party that felt that the government has no business being in an exam room, standing between me and my patient? Where did the party go that felt some decisions in a woman's life should be made not by legislators and government, but rather by the women, her conscience, her doctor and her God?

Dr. Doug Cox (R-Grove) has delivered more than 800 babies.

the best ways to eliminate abortions is to ensure access to contraception

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Providing birth control to women at no cost substantially reduced unplanned pregnancies and cut abortion rates by a range of 62-78 percent compared to the national rate, a new study shows.

The research, by investigators at Washington University School of Medicine in St. Louis, appears online Oct. 4 in Obstetrics & Gynecology.

Among a range of birth control methods offered in the study, most women chose long-acting methods like intrauterine devices (IUDs) or implants, which have lower failure rates than commonly used birth control pills. In the United States, IUDs and implants have high up-front costs that sometimes aren’t covered by health insurance, making these methods unaffordable for many women.

“This study shows that by removing barriers to highly-effective contraceptive methods such as IUDs and implants, we can reduce unintended pregnancies and the need for abortions,” says lead author Jeff Peipert, MD, PhD, the Robert J. Terry Professor of Obstetrics and Gynecology. ...

Participants had their choice of birth control methods, ranging from long-acting forms like IUDs and implants to shorter-acting forms like birth control pills, patches and rings.​

Peipert

The women were counseled about the different methods, including their effectiveness, risks and benefits. The extremely low failure rate (less than 1 percent) of IUDs and implants over that of shorter-acting forms (8-10 percent) was emphasized. In all, about 75 percent of women in the study chose IUDs or implants.

From 2008 to 2010, annual abortion rates among study participants ranged from 4.4 to 7.5 per 1,000 women. This is a substantial drop (ranging from 62-78 percent) compared to the national rate of 19.6 abortions per 1,000 women in 2008, the latest year for which figures are available.

The lower abortion rates among CHOICE participants also is considerably less than the rates in St. Louis city and county, which ranged from 13.4 to 17 per 1,000 women, for the same years.

Among girls ages 15-19 who had access to free birth control provided in the study, the annual birth rate was 6.3 per 1,000, far below the U.S. rate of 34.3 per 1,000 for girls the same age.

While birth control pills are the most commonly used reversible contraceptive in the United States, their effectiveness hinges on women remembering to take a pill every day and having easy access to refills.

In contrast, IUDs and implants are inserted by health-care providers and are effective for 5 to 10 years and 3 years, respectively. Despite their superior effectiveness over short-term methods, only a small percentage of U.S. women using contraception choose these methods. Many can’t afford the cost of IUDs and implants, which can cost more than $800 and may not be covered by insurance.

“Unintended pregnancy remains a major health problem in the United States, with higher proportions among teenagers and women with less education and lower economic status,” Peipert says. “The results of this study demonstrate that we can reduce the rate of unintended pregnancy, and this is key to reducing abortions in this country.” ... "

(god says we can't) ask for anything more.