A Hole in Our Rubber Soul

The simple mechanics of pregnancy prevention are straightforward and, luckily, cheap.  Nevertheless, though condoms are plentiful, easy to use, and ribbed, scented, and flavored, about fifty percent of American pregnancies are still unintended.  This is not, as many religious sources would have you believe, due to the incredibly high rate of condom failure.  Not surprisingly, it's the result of layer upon layer of prejudice and misinformation.  Several centuries after its invention, the rate of condom failure is still much lower than the rate of condom ignorance.

It begins with the way that the media depicts condoms, and the way that it presents sex.  Sex is everywhere on TV, including on the Disney Channel and the Food Network.  Yet condom commercials are much harder to come by. You certainly haven't seen them on ABC, home of the wholesome "Gray's Anatomy" an "Desperate Housewives," which refuses to air any condom advertising.  Other networks may allow condom advertisements, but most have restrictions on the types of commercials that can be shown, and the times that they can run.  Perhaps most egregiously, Fox and CBS mandate that any condom advertising shown on the network "must not focus on pregnancy prevention."  In the same way, birth control pills can be advertised, as long as they are marketed as primarily as treatments for acne and PMS.  Interestingly, these same restrictions do not apply to commercials for products such as Viagra or Cialis.

Condom Ad Rejected by Fox

I am certainly not belittling the importance of HIV prevention. Yet mandating that condom commercials focus only on disease prevention, and not on unwanted pregnancy, seems a bizarre dichotomy to draw.  In fact, prior to the emergence of the AIDS crisis, condom advertisements were not allowed on TV at all.  Focusing on HIV risk makes sex dirty and dangerous, while advocating pregnancy prevention would imply that fun, non-procreative sex is something to be celebrated.  I guess that Fox executives can congratulate themselves on having made pregnancy prevention an obscenity, and one even greater than sex itself.

The mere logistics of purchasing condoms is further testament to the disconnect between our views of contraception and our appetite for sex.  In most drugstores, condoms are segregated to a special shelf, usually right below the pharmacist's watchful eyes; in other cases, they are locked up, and store patrons must have an employee assist them in their embarrassing purchase.  It is awkward enough to remove condoms from their glass prison when you're in your twenties or thirties; I can only imagine how difficult it is for a 16-year-old to ask someone to unlock a condom case.  Unfortunately, condoms have been locked up primarily because they are so often shoplifted, likely by those too embarrassed to bring them to checkout.  Then the condoms are locked up, the awkwardness increases, and an infinite cycle begins.

http://thecurvature.com/2009/02/12/cvs-limits-condom-access-for-some/

These magical locked cases can only be opened with a wedding ring.

To better promote safe sex amongst teenagers, progressives such as Joycelyn Elders have advocated dispensing condoms in high schools.  Massachusetts has implemented this practice in many of its schools, with great significant reduction in teen pregnancy rates.  Yet I doubt that other states will take the cue from Massachusetts any time soon, because I'm just not that naive.  Indeed, the "War on Condoms" is being waged full-force in high schools, as well as in our drugstores an on our airwaves.

http://www.zazzle.com/if_used_correctlynot_100_effective_condoms_e_tshirt-235300270078506145

Seriously, ya'll!  If used correctly, not 100% effective condoms everytime!  Wait, what?

In the abstinence-only programs served up to most of America's teenagers, condoms are only mentioned as being so ineffective that they are not worthy of discussion.  This is the direct of the widespread fear that frank discussion of condoms will incite premature sexual activity, in the same way that not teaching teens about condoms has successfully kept sex a complete secret.  For this reason, teenagers educated in abstinence-only programs are far less likely than their more savvy counterparts to use condoms when they inevitably become sexually active.  I feel like it's understood that essentially all products have some non-zero failure rate, yet condoms, with their 98% rate of effectiveness, are held to the highest standard and get by far the worst rap.  Notice how we never see "Chemotherapy:  Not 100% Effective" or "Prayer:  Not 100% Effective"?

Amid the shame, secrecy, and slander surrounding condoms, thousands of lives are still being ruined each year by unintended pregnancies in tragic and needless accidents that could have been prevented by a 25-cent piece of latex.  I expect that someday I'll get around to making the choice to have a child, and when I do, I will love that child enough not to value an arbitrary standard of morality over his or her safety.  My kid will get a big gift-wrapped box of condoms on its 16th birthday.

The Shutdown Gets Shut Down

Last week, an epic struggle over abortion rights was waged on the Senate floor, the most dramatic such debate in at least two weeks and the likes of which will only be seen five or six more times before the end of 2011.  With just an hour to go until complete and total anarchy (in the way of closed post offices and a parking free-for-all), the government shutdown was halted when the Republicans conceded defeat in their Game of Chicken and generously agreed to devote 0.008% of the federal budget to Planned Parenthood.

http://thefeministgriote.com/?p=775

Here are just a few things that we learned in the week leading up to the Shutdown:

• "Big Abortion" is something we should be worried about.
• Abortion constitutes over 90% of Planned Parenthood's services.
• You can get a mammogram and a Pap Smear at Walgreens.

http://www.newshounds.us/2011/04/12/brian_kilmeades_misogynistic_mocking_of_planned_parenthood.php

Now, while it is evidently permissible in political discourse to use absolutely any fabricated fact or preferably a bullshitted statistic to support your argument, it still remains the case that abortions constitute only 3% of Planned Parenthood's services, and Section 1008 of Title X already prohibits these abortions from being funded by federal dollars.  Yet, in just the same way that all women entering a PP facility for any reason are harassed indiscriminately, so too were the 97% of PP services that are not abortion-related to be defunded in the right's war of attrition on abortion and women's health.

This all leaves me utterly baffled as to what's truly at the root of the debate, because its clearly not the deficit.  I do, however, have my pet theories.  First:  America's religious, corn-fed middle and lower classes care more about fetuses than about women, to put it simply.  Babies have the fortune of being cute and innocent, whereas women have had sufficient time to fuck up in some aspect of life.  I can't tell you how many times I've come across this viewpoint just in perusing other Blogspot blogs and Facebook pages:  babies are sweet, innocent, and "gifts from God," and women who are not interested in producing more of them are whores, murderers, or both.

Second: America is viscerally afraid of and opposed to sex.  We are dedicated to denying that sexuality is a natural and universal aspect of life, whether we are married or single, straight or gay, trying to procreate or not.  Women's health services pertain to STDs, pregnancy, and the general state of having genitals - all of which are matters relate to sex.  Thus, Planned Parenthood falls into the category of "things your parents get awkwardly silent about and hope you don't notice," along with condom commercials and softcore porn mags.  So why devote funds to preventing the byproducts of sex - STDs, pregnancy, and cervical cancer - when these things only happen to bad people who are just getting what they deserve?

Luckily, the joke is on detractors of women's health, because donations to Planned Parenthood have increased 500% since the funding debate first began.  Evidently, there are people other than myself who feel that saving money by not providing condoms to low-income populations may not be the best cost-reduction approach in the long run.

A Call to Arms (and to Scalpels)

Three cheers for America's judicial system.  It may be the least-appreciated branch, the "Holy Spirit" of the federal government, so to speak, but for almost 40 years now it has firmly upheld Roe v. Wade against countless legal attacks to repeal and undermine it.  In the past few decades, however, slander, intimidation, and yes, even pro-life terrorism have been much more successful than legislative initiatives at chipping away at the right to choose. The pro-life side has managed, through numerous back-door approaches, to make obtaining an abortion difficult and humiliating, if still technically legal.  Today, the biggest threat to abortion rights in the US is not the legality of the procedure, but rather the logistical access to abortion services, due in large part to the near crisis-level shortage of practicing abortion providers in the US.

Abortion remains one of the most commonly-performed procedures in America, and is certainly one of the most often discussed.  Therefore, it probably surprises most people to learn that physicians who perform abortions (or "abortionists," as they are so often called) are few and far between.  As in "entire states of separation" far between.  If you need an abortion and live in Wyoming, Missouri, Mississippi, or, God forbid, Hawaii, you are shit out of luck:  these four states lack a single abortion provider.  Even in states with relatively progressive abortion laws access to abortion is hindered merely by the scarcity of providers.  In fact, the 1.21 million abortions performed in 2008 were provided by just 1,793 facilities, with half of these services provided by just 2% of OB-GYNs.  In contrast, the nation is blanketed by well over 4,000 crisis pregnancy centers.

http://www.catholicvoteaction.org/americanpapist/index.php?tag=pro-life

It's not difficult to imagine why so few physicians provide abortions.  Clinic bombings, "abortion hit lists," Bill O'Reilly's abortion witch-hunt, and the 2009 assassination of Dr. George Tiller have all achieved their intended effect:  terrifying physicians out of providing a legal and judicially-protected procedure.  There are additional factors at play as well.  Catholic hospitals, which employ around 16% of American doctors, prohibit their employees from performing abortions even to correct an ectopic pregnancy or other life-threatening complication.  Many OB-GYNs aren't even trained in the procedure, as fewer than half of residency programs require this training.  And even physicians who identify as pro-choice may be reluctant to perform abortions due to societal pressures and the awkwardness of rarely being able to discuss their work in polite conversation.

http://worstgenerationseed.blogspot.com/2009/03/truth-truck-meets-tiller-killer.html

As a very pro-choice pre-med, these matters have been on my mind for some time now.  The nation needs abortion providers.  Women need abortions, and they will not stop needing (and procuring) them just because their doctors are incompetent or untrained.  I will someday need a specialty, and I believe in providing a service that millions of women want and need.  Of course, now is not the time to commit to a career:  even by the most optimistic estimates, it will be more than five years before I have my MD.  And regardless of how passionate I am about the cause, I'm not sure whether I'm prepared for a career that will spell a lifetime of harassment, fear, disdain, and maybe even a bullet to the head.  But it's something to consider.

http://www.theologyonline.com/forums/showthread.php?t=66908&page=2

The Rosaries in the Ovaries

In spite of the Catholic Church's continued and unwavering stance against birth control, it turns out that most American Catholics are, not surprisingly, hypocrites.  According to the National Survey of Family Growth, about 98% have used a form of contraception banned by the Vatican at some point in their lives, and 40% identify as pro-choice.  No word yet on whether these sins come up during Confession.

http://puzzledponderer.wordpress.com/2010/04/28/most-ridiculous-catholic-clothing-ever/

Yet in the developing world, particularly in Latin America and Africa, the Pope's anti-birth control, anti-condom opinions are taken more seriously.  In Catholic nations such as the DR Congo, Peru, and Haiti, rates of birth control use are negligible, and are inversely correlated with rates of HIV infection and unwanted pregnancy.  In Kenya, there have even been widely-reported instances of condom-burnings at the behest of Catholic bishops.

Now, even Pope Paul VI, composer of the treatise Humanae Vitae, acknowledged that couples might "decide not to have additional children" after giving due consideration to "physical, economic, psychological, and social conditions."  And so, to "keep up with the times," ta-da! - thus was born the Catholic institution of Natural Family Planning.  NFP is a complicated system of tracking fertility by taking one's temperature, recording daily levels of cervical mucus secretions, and filling out charts.  This enables a Catholic couple to attempt to avoid pregnancy by abstaining from sex on likely fertile days, while not "perverting the purpose of the marital act."

http://www.learkentfool.com/?p=1678

First, let's be honest:  NFP is birth control.  It's just complicated and ineffective birth control.  Second, Catholicism seems to be very arbitrary with its endorsement of all things "natural:" naturalness is something to be embraced in contraception, but to be shunned when keeping PVS patients alive for decades via ventilators and feeding tubes.

Third, I don't see how this birth control method stands up even to Catholic logic.  The line of reasoning seems to go:  "Sex that isn't open to procreation is wrong.  If I use a condom then God will be displeased, because I'm trying to prevent pregnancy.  But if I have sex according to an intricately-designed calendar, God won't be able to see through my intention.  God wants me to have babies whenever he chooses.  God can do anything.  But he can't surmount a latex barrier even when he really, really wants to."

http://babymakingmachine.blogspot.com/2009/04/natural-family-planning-techinique.html

Sure gets me all hot and bothered.

Anyway.  Couples hoping to marry in a Catholic church are now required to attend four-month classes in Natural Family Planning, to learn the ins and outs of cervical mucus charting and the evils of secular methods of birth control.  For those unable to attend a class, the marriage requirement can be fulfilled with a "home study" class for just $161.  Nevertheless, NFP use is not very common in the developed world, even among Catholic women.  In fact, only about 3.6% of Catholics practice NFP.  Still, for the very high and holy, Natural Family Planning is the one and only way to go.

Given that the Catholic stance against birth control is so often criticized for the plight of starving, HIV-ravaged third world countries, I was curious to see whether NFP had made its way to Latin America and Africa.  Surely, since the Church acknowledges that everyone might not want to procreate constantly, and since it is so concerned with preserving human life, it would try to promote its one approved method of birth control in the third world.  I discovered, however, that NFP courses are available - in English and Spanish only - in all of fifteen nations worldwide.  The majority of these nations (the US, Canada, Great Britain, Ireland, Argentina, Spain, South Africa, and inexplicably, China) are already highly developed.  NFP classes are taught in just six countries total in Africa and Latin America.  Furthermore, according to Natural Family Planning International, current efforts are focused on bringing NFP to the Czech Republic, a country with a fertility rate of 1.24 births per woman, whose people have suffered from "secularism and immorality."  In third-world majority Catholic nations, however, I suppose that the "suffering" has not been so great.

One rare instance I could find of Catholics promoting NFP in the third world comes from my very own Jesuit Georgetown.  A cohort of Jesuits affiliated with the Institute for Reproductive Health is attempting to dispense "cycle beads," rosaries for counting days of the menstrual cycle instead of Hail Marys, in Rwanda, Guatamala, and the DR Congo.  The sad fact is, though, that in the DR Congo, the so-called "rape capital of the world," where girls are often married off at puberty, even a woman's husband is unlikely to respect her wishes to abstain from intercourse during a fertile period.

If Catholic couples truly want to practice Natural Family Planning, then of course that is their right and their choice.  What I'd like to see, however, is some admission that this form of birth control is an elitist luxury, akin to buying organic food or running in Nike Nakeds.  For reasons logistical, economic, and societal, NFP is available almost exclusively in the developed world, while those without easy access are still told that condoms and other forms of "artificial" contraception will drag them down into the depths of Hell.  Yet even faced with these criticisms, the Vatican is as determined as ever not to waver in its resolve.  Pope Benedict XVI, speaking in 2008 on the 40th anniversary of Humanae Vitae, firmly supported his predecessor's treatise, and reminded the world's one billion Catholics that the Church's stance against birth control is "so crucial for humanity's future."

And I would have to agree with him there.