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Between shouting and silence, a way forward
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Date Posted on this Site
June 23, 2006
Publication
Ottawa Citizen
Publication Date
May 29, 2006
Published Content
Between shouting and silence, a way forward
Kate Heartfield
In the United States, public comment about reproductive health is as predictable as it is noisy. A research institute puts out a report called "Abortion in Women's Lives," and shouting ensues.
Before we get too comfortable on our high horse, it's worth noting that Canadians have few such reports to shout about, or even to discuss politely. We just don't know enough about the reproductive choices of Canadian women.
The U.S. report is a fascinating one, so it's too bad so much of the reaction there has been of the vein-popping variety. The Guttmacher Institute, whose mission is to "protect the reproductive choices of all women and men", analysed all kinds of data about when and how and why women have abortions, and what the consequences are.
According to its report, there is no evidence that abortions create long-term health problems in women. That conclusion has enraged anti-abortion commentators and lobby groups, and a few have made solid criticisms of the report. Many, though, seem content to rage. Some falsely accuse the report of saying that abortion is "harmless" and proceed to attack that assertion.
Meanwhile, nobody's shouting about the significant news in the report: upper- and middle-class women are having fewer unplanned pregnancies than they were in the George H. W. Bush era, but poor women are having more.
Between 1994 and 2001, the unplanned-pregnancy rate rose by 29 per cent for women living under the poverty level, while it fell by 20 per cent among better-off women.
The anti-abortion groups Concerned Women for America and the Silent No More Awareness Campaign didn't bother to address that in their angry responses to the report. Those anti-abortion critics who did address it shrugged it off as evidence of immorality.
That dismissal is not only insulting, it also fails to explain the numbers. There's no reason to believe poor people have become more immoral since the early 1990s, or that wealthy people have become less immoral in that time. Social conservatives could argue that the pregnancy rates show that all of society is going to hell in a hand-cart, but they'd have to explain why the dissipated Hollywood liberals and east-coast Democrats aren't getting pregnant in greater numbers while poor women are.
No, the numbers in the Guttmacher report lead to one conclusion: Whatever the United States is doing to prevent unplanned pregnancies is helping rich women and hurting poor women. That's a serious problem. It's a shame so few critics and commentators are paying attention to it. Perhaps, if the analysis of pregnancy trends had not been part of a report full of controversial findings about abortion, that analysis would have engendered some reasonable commentary and discussion.
The study also found that the proportion of women having unprotected sex decreased in the 1980s, but it increased again in the 1990s, and "non-use of contraception has risen more sharply among poor women and women of colour."
Women who have sex without effective contraception are more likely than other women to get pregnant: They are also more likely to have abortions. It all makes sense, but it presents a problem for anti-abortion activists who also oppose sex education and accessible birth control.
The fundamental question is: Why aren't poor women using effective contraception? Why is this problem getting worse?
Even the Guttmacher report doesn't delve very deeply into that. It does suggest the blame lies with abstinence-only education programs, inadequate health insurance, and restrictions on public funding for social services that counsel women about contraception and abortion. Those certainly seem like good places to start looking for the sources of the problem.
The political, social and economic situation in Canada is not identical to that in the U.S., so I have no idea whether poor women in Canada are having more unwanted pregnancies than they were 15 years ago.
I asked Linda Capperauld, the executive director of the Canadian Federation for Sexual Health, where I could find Canadian data to compare to the Guttmacher report.
"Would I ever like to see a study of this for Canadian women," she said. Last I heard, she was still looking for one.
I'd like to think that, if somebody did such a study here, Canadians would talk rationally about it, whatever the results. We might talk about the cost of prescription birth control or the availability of services in rural areas. But for the time being, we've got nothing to talk about. Our neighbours are shouting. We are silent.
Kate Heartfield is a member of the Citizen's editorial board.
My Response Letter
Kate Heartfield is right. No one is shouting about the most important parts of this report: only five per cent of women in the U.S. have unintended pregnancies each year, and of those that do have unintended pregnancies, fewer than half of them choose abortion.[1] Even the overall rate of abortions in the U.S. is declining.[2] Of course, this is not what the report's authors want people to hear, so they focus on the only hiccup: a slight increase in unintended pregnancies among poorer women (even as poverty levels in the U.S. were also increasing.[3]) Sometimes people need to shout in order to be heard.
[1] http://www.guttmacher.org/media/nr/2006/05/04/index.html
[2] http://www.guttmacher.org/pubs/fb_induced_abortion.html
[3] http://www.census.gov/Press-Release/www/releases/archives/income_wealth/002484.html
Jason Gennaro
Was my response published?
Yes
Download an image of the published letter
Did I get a response?
Yes
Thanks for writing. You make an interesting and important point.
Kate Heartfield