Preaching to the Choir

With a little less than half of the U.S. self-identifying as Pro-Choice, it's easy for us to stick together.  When you're young, hip, sexy, and buying quinoa from Trader Joe's, it's even easier.  Sex and Choice are natural conversation points at parties.  Supporting Planned Parenthood is taken as a given.  Some of us may even blog for an intended audience already in agreement.  For people like us, there are rallying points like this great video:

Wesleyan University - "I Have Sex"

And this more cloying one:

Second City - For Those With Vaginas

But preaching to the choir only goes so far to effect actual change.  Eventually, we actually need to mobilize our fervent energy and bring our concerns and our message to the other side, to those who don't already agree with us, to those who are uncomfortable with our position.  Accordingly, today I performed my most futile of civic duties:  I wrote a letter to my Senator, ultra pro-life Saxby Chambliss (R - GA Douchebag).  Note how I pretended that "budget cuts" are really the issue at hand:

"Dear Senator Chambliss,

I am writing to express my concerns about measures currently under consideration regarding reproductive health.  In the ongoing Congressional debates on FY2011 budget cuts, you have voted to defund both the United Nations Population Fund and Planned Parenthood.  I ask that you reconsider your stance on these issues, and lend your support to these vital organizations.  I am one of your constituents, and a citizen concerned both with the nation’s growing deficit, as well as with the impact of unintended pregnancies both at home and worldwide.  I believe not only that these two causes are related, but that they are intricately and inextricably linked.

First, I urge you to vote in support of providing funding to the United Nations Population Fund.  This organization does not fund abortions, but rather provides desperately-needed access to family planning resources and education to millions of young women and men around the world.   In addition, the UNFPA also provides medical care to pregnant women in an effort to decrease the enormous number of maternal deaths and injuries that occur each day.  These measures, which allow women in the developing world to determine the size and spacing of their families, have proven their positive impact.  Nations with fewer unintended pregnancies, smaller family size, and fewer maternal deaths are more stable socially, economically, and politically.  Such improvements would spell positive changes for our global community.

Second, I ask that you support federal funding for Planned Parenthood, an organization which provides family planning and health services to millions of Americans.  The mission of Planned Parenthood is to prevent unwanted pregnancy, allowing women and girls to complete their educations and further their careers, and saving millions of dollars each year in Medicaid and Welfare costs.

I understand the severity of the nation’s current financial situation, but I firmly believe that cutting funding from family planning programs is not the way to save money.  I am sure that you have heard the saying that every dollar spent on family planning measures saves four down the road.  Thus, in this time of economic crisis, it would behoove us as citizens of Georgia, the United States, and the world to invest in women’s future and in fiscally-sound family planning measures.

Thank you."

Naturally, my letter is going to end up being ignored.  Actually, it's not even going to be ignored by Saxby Chambliss; it's going to be ignored by Saxby Chambliss' secretary's intern.  But I'm glad that I finally voiced my dissident opinion to someone who is supposed to be representing me.  And maybe a hundred such letters would be harder to ignore.

Happily, Planned Parenthood is safe for now, but the failure of H.R. 1 bought only about three weeks of time.  The threat of budget cuts is not going anywhere.  So I'm going to go all PSA on ya'll and beg you 1) To donate to Planned Parenthood, and 2) to write to your Senators and Representatives.  Feel free to copy and paste my letter, emend it, or ignore it and write your own.  If you give a shit about this cause, please tell someone.  And don't let me be that someone.  Make it someone who doesn't already know.

Embarrassing Moments in History: Joycelyn Elders

I firmly believe that the first step in bettering life both at home and abroad would be drastically lowering the rate of unintended and unwanted pregnancies, while simultaneously cultivating healthier attitudes about sex.  Thus, I blog.  Yet my views really aren't all that radical.  They sound basic and intuitive enough, and completely in line with Whole Foods-shopping, NPR-listening liberal ideas.  Yet in practice, in the real world, we are still far away from realizing these standards.  To emphasize this point, I'd like to tell a sad story from (recent) history.

In 1993, Joycelyn Elders, pediatric endocrinologist and expert in childhood sexual development, was appointed the 15th Surgeon General by Bill Clinton.  At that time, the teen pregnancy rate was 11.1%, HIV rates were on the rise, and accordingly, the nation turned to the new Surgeon General for insight and solutions. From the start, however, she was unpopular with conservatives and the Democratic Clinton administration alike, and incited controversy through her support of abortion rights, marijuana legalization, and distribution of contraception in high schools.    

http://en.wikipedia.org/wiki/Joycelyn_Elders

Unfortunately, Dr. Elders offended polite sensibilities one too many times when she suggested in December 1994 that masturbation be taught to students as a form of "safe sex," in order to prevent HIV infections and teenage pregnancies.  Her exact words on this topic were "I think that it is a part of human sexuality, and perhaps it should be taught."  These comments fomented considerable  following day, she was sacked by Clinton, who stated that this most recent indecency was "the last straw."  This was approximately one year before he stuck a cigar into an intern's vagina.

http://www.mediabistro.com/fishbowldc/monica-lewinksys-drudge-anniversary_b28876

Claiming that "masturbation is bad" depends on what the definition of "is" is.

In 1996, following Dr. Elders' removal from office, the U.S. famously instituted a nation-wide program of "abstinence-only education," which invested $1.5 billion of taxpayer dollars in attempting to terrify American students out of having premarital sex.  Years later, the rate of pre-marital sex remains steady at 95%, teen pregnancy rates are back on the rise, and millions of American students are still being told not to touch themselves or anyone else in a "special way."

http://spendmoneyonline.net/2008/02/01/anti-masturbation-device-french-c1880/

Anti-masturbation device.  Sin-proof, Clinton-proof.

I myself was one of these students who came up in an abstinence-only sex education curriculum in Georgia.  The majority of our education consisted of horrifying images of STDs, greatly exaggerated statistics about the inefficiency of condoms, and exhortations to "resist peer pressure" - since, naturally, teenagers only want to have sex when pressured to do so by other teenagers, not because it actually feels good or is encouraged by millions of years of evolution.  Masturbation came up exactly once in the discussion, surrounded with plenty of Georgia-variety hellfire and brimstone.  

Given that realization of the futility of such programs has led to some budget cuts, however, I wondered if the Richmond County Board of Education had changed its stance on abstinence-only education.  Having found no relevant information online, I called the Richmond County School Board's office last week to inquire about its current sex education policies.  After the nice lady on the phone offered to transfer me, I was promptly disconnected.  Now, given my familiarity with this particular office, I attribute this carelessness to general ineptitude rather than to some kind of grand conspiracy.  Nevertheless, further inquiry revealed that Georgia is one of 27 states still required by law to focus primarily on abstinence in sex education, and that its abstinence-only-until-marriage programs received almost $10 million in 2009.

http://community.babycenter.com/post/a25578437/featured_debate_teen_pregnancy_and_religion

Georgia ranks 13th in the nation for teenage pregnancy.  Ooops.

In the nation with the highest teen pregnancy rates in the developed world, we inexplicably still pretend that abstinence until marriage is somehow a realistic goal.  Abstinence without masturbation, however, is about as realistic as trying to get America to actually follow the guidelines of the Food Pyramid.  While the importance of contraceptives needs to be emphasized over and over again ad infinitum to middle and high schoolers, the safest place for teenage semen is still in a sock, and the most effective and comprehensive sex education programs should acknowledge that.  Alas, Joycelyn Elders' suggestion was, and still is, far ahead of its time.  This is because for much of the nation, the priority remains not decreasing the overall rate of teenage birth, but promoting some kind of unattainable, Old Testament standard of sexual purity of which even Sarah Palin's children fall short.  We can only hope that a few more decades of these results may change our attitudes.  

Until then, Joycelyn, our hats (and our panties) go off to you!

The Utility of Choice

As a matter of reason, good taste, and, well, the entire principle of separation of church and state, Bible verses have no place in political discourse.  However, it's unsurprisingly difficult, if not impossible, to disentangle the abortion debate from religion.  The Bible apparently has a lot to say on the matter, since most pro-life websites are headed with quotes from the Book of Proverbs, images of a pained and sorrowful-looking Virgin Mary, and (the ultimate trump card) the question "What if Jesus had been aborted?"

What you don't hear much of are utilitarian arguments against abortion.  In a nation faced with a growing deficit and heinous unemployment, the far right still doesn't seem interested in forming logical social and economic justifications for its endless effort to overturn Roe v. Wade.  Now, I am fully on board with decreasing the national deficit and bettering overall quality of life, so I think we would do well to transfer the abortion debate from the religious to the practical sphere.  From a small-government, fiscally-responsible standpoint, are there any positive external effects of legally requiring a woman to carry an unwanted pregnancy to term?

http://intenseproductions.blogspot.com/2010/08/practicing-your-scales-effectively.html

Weighing pro-life against pro-quality of life.

The term "utilitarianism" scares us, or at least makes us uncomfortable.  We like to fancy ourselves ethical, to think that we don't "cut our losses" when it comes to issues of morality.  Yet we make a utilitarian bargain every time we eat meat or wage war.  So how do we apply these calculations to issues of reproductive choice?

First, there is the issue of population.  In a matter of months, the world's population will hit 7 billion; by 2030, it will be over 8 billion.  Needless to say, this "population bomb" will have far-reaching implications on the environment, politics, economics, and general quality of life.  Basically, everything.

http://www.blogiseverything.com/general/worlds-population-graphs/

This graph should scare the shit out of you, and if it doesn't, you probably lack basic abilities of projection.  Now add to this stunning rate of growth the fact that even in the United States, where contraception is readily available, half of pregnancies are unintended or unwanted.  This leaves us with a rapidly exploding world population of 7 billion people, at least one half of whom were born to parents who didn't want them, or didn't have the maturity or resources necessary to raise them.  Would illegalizing abortion impact these statistics positively?

Then there are the social effects of abortion.  As we learned from Freakonomics, the legalization of abortion in America corresponded with a decrease in the crime rate.  Similarly, there are indications that abortion lowers the incidence of child abuse.  Correlation doesn't imply causation, of course, and both these claims are surrounded with controversy based on statistical approachs to the questions.  Nevertheless, we can imagine how unwilling parents would be more likely to lash out at an unwanted child, and unwanted children more likely to last out at society.  And then there is the fact that abortion actually saves money:  by conservative estimates, each dollar spent on family planning saves us almost four down the road, in Medicaid and welfare costs.  Would defunding Planned Parenthood or overturning Roe v. Wade better financial stability and quality of life?

Finally, there are the effects of abortion on women themselves.  The pro-life side loves this argument, because it is a perfect opportunity for them to rail against abortion while pretending to care about women's rights and health.  From this ostensible concern has arisen the concept of "Post Abortion Syndrome," a mental-health condition which supposedly causes flashbacks, depression, and suicidal thoughts in 50% of women who have abortions.  

But alas, as much as the pro-life camp wishes that it existed, it turns out that studies which supported "PAS" were fraught with statistical errors, and it's actually just a load of shit.  When compared to women of similar socio-economic backgrounds who decided to carry their pregnancies to term, women who have had abortions actually fare the same, and often better, in terms of mental health.  Not surprisingly, being able to finish an education or further a career, remaining financially stable, and not having to bear and raise an unwanted child actually has positive effects on a woman's well-being.  And this isn't even touching the fact that Roe v. Wade ended the bloody era of coat-hanger abortions.

I haven't said a single thing here that hasn't been regurgitated time and time again.  That doesn't, however, dilute its significance.  Allowing women to take charge of their own reproduction has far-reaching positive implications, and I know not of any non-religious, practical justifications for the other side.

A fetus does not have a fully developed nervous system, lacks self-awareness, and cannot feel pain until at least 24 weeks of gestation.  In these regards, it ranks somewhere between a jellyfish and a salamander.  Thus, any concern felt for a fetus in another person's body can only be for its nebulous "soul," and thus can only be religious.  Naturally, this realization isn't likely to send shockwaves through a country of which 90% self-identifies as religious, and I would have to be fairly naive to pretend that the barrier between church and state is impermeable.  But let's make that barrier a latex barrier, and keep the pro-life separate from the pro-quality of life. 

International Women's Day

For a few years now, I've been hearing about the 8th of March's celebration of "International Women's Day" from my very Bulgarian boyfriend.  This very Socialist holiday is Valentine's Day and Mother's Day rolled into one, but I'd never heard of it from anyone besides Nikolay. Today, however, while walking in the streets of Madrid, I saw Spanish women carrying roses, and signs and banners commemorating the 100th annual Women's Day.  Turns out the Bulgars didn't make it up.

In honor of this festive and feminist occasion (and given that my sojourn in Spain doesn't give me much time to write a blog post!), I wanted to post an extremely relevant film.  It runs almost an hour, but it is well worth the time.

http://www.answers.com/topic/a-walk-to-beautiful-1

Film: A Walk to Beautiful

This award-winning documentary focuses on five Ethiopian women living with obstetric fistula, a devastating yet reversible injury incurred during childbirth.  If you have never heard of obstetric fistula, I am not going to describe it here - just be aware that there are complications of pregnancy far worse than going into labor in a taxi or elevator, as per sitcom convention.  

According to the UNFPA, approximately 2 million girls and women worldwide currently suffer from this condition.  Obstetric fistula almost exclusively affects women from impoverished regions who give birth before the age of 18.  Married off before puberty and impregnated through what would most tactfully be called statutory rape, the girls unlucky enough to develop a fistula endure their condition along with the disgust of their husbands and the rejection of their communities.

The documentary is poignant but not preachy, powerful, yet not overdone.  The disclaimer at the beginning of the film warns the viewer that the subject material is "mature."  Unfortunately, there are some aspects of pregnancy too unpleasant for baby shower games, and not cute enough for a TLC special.  In a nation that loves to raise its voice about choice vs. life, Roe vs. Wade, we so rarely discuss the victims who suffer most at this crossroads of culture, politics, and religion:  young, impoverished girls who have never had a "choice" about anything.

Crisis

http://www.impact73.org/Lifeboards.php

Project Lifeboard offers you "options," but not "choice."

This week there was some good news in the world of Choice.  According to the NYC city council, Crisis Pregnancy Centers, pro-life organizations which disseminate ads like the one seen above, must now specify in their ads 1) what specific services they provide, and 2) whether or not they hold a medical license.  Baby steps, but steps in the right direction.  This is some progress, but I am far from satisfied, for numerous reasons.

These centers usually present themselves as medical clinics offering abortions and other pregnancy services, though their true purpose is to dissuade girls experiencing an unwanted pregnancy from having an abortion, and often to win Christian converts along the way.  Most centers are in fact unlicensed and staffed solely by religious volunteers and medical assistants – people who have had less than 6 months of medical training.  The only services offered are pregnancy tests and ultrasounds.  Even more absurd are the tactics used to wheedle girls into choosing to keep a baby:   “patients” at these centers are shown footage of a fetus’ beating heart, are encouraged to marry the baby’s biological father, and receive blatantly incorrect medical information about the dangers of having an abortion. 

According to the website of Ramah International, an alliance of pregnancy centers,  there are a few things I should know if I am considering an abortion:  1)  Abortion is a risky procedure, often performed in unsanitary conditions.  2)  Following an abortion, I am 33% more likely to experience an ectopic pregnancy, 50% more likely to develop breast cancer, and 600% more likely to experience abruptio placenta. 3)  Following an abortion, I have a 50% chance of developing “Post-Abortion Syndrome,” which leads to depression, anxiety, and suicide.  4) My fetus can feel pain beginning at 9 weeks.  And, most ridiculous, 5) I should first take a pregnancy test at the center, because THE DOCTOR WHO TOLD ME I WAS PREGNANT MAY HAVE LIED IN ORDER TO SELL ME AN ABORTION.

These claims are all false, as well as ridiculous (honestly, has a doctor ever told someone he had cancer in order to “sell” him a surgery?)  It is one thing to run an establishment dedicated to spewing hellfire and damnation of the religious variety on women who are in genuine distress.  It is quite another, however, to disseminate deliberately false medical information in an effort to terrify and manipulate women into making what will probably be one of the most important decision of their lives.  Imagine a scared, pregnant 16-year-old girl entering what she thinks is a medical clinic, being told that she has a ~50% chance of dying from the long-term effects of an abortion, and making a decision to keep and raise a baby based on that information.

But lest you think that this is the last stop on the Crazy Train, 20 US states currently provide funding for these Crisis Pregnancy Centers (my own native Georgia being one of them).  These are tax dollars, being spent on a service that masquerades as something it’s not and then lies directly to its clients.  This is like spending state money on a fire station which pretends to be a restaurant and then tells customers that too much friction during sex will cause a forest fire.  And these are the tax dollars we can’t afford to allocate for family planning.

Though NYC has voted to begin regulating its centers’ advertising and similar measures have been enacted in Maryland, such legislation has failed in most staes.  Nationwide, crisis pregnancy centers outnumber abortion clinics 4 to 1, and receive approximately $25 million of state and federal assistance.  Using tax funds to encourage teens to marry and raise children, without providing them with the appropriate pre- or post-natal care or contraceptive options?  Makes fiscal sense to me.

Pregnant?  Alone?  Confused?  For the love of God, go to a real doctor.

Dividing Cells, Splitting Hairs

In his 1968 encyclical Humanae Vitae, a treatise condemning the use of contraceptives, Pope Paul VI famously established the Catholic church's official stance on all matters procreative.  In the 40-odd years since the publication of Humanae Vitae, the Church has not budged it its contra-contraception position, and Pope Paul VI's treatise has been lauded as "prophetic"for how it anticipated today's issues of reproductive ethics.  These aren't just echoes of the "be fruitful and multiply" argument, however.  Supporters of the Church claim that the Pope's views on birth control are even more relevant given that chemical contraception is "known" to induce abortions through preventing implantation of a fertilized embryo.  Thus contraception is not a lesser, separate evil, but is tantamount to abortion itself.

http://stemcells.nih.gov/info/scireport/appendixa.asp

A life begins... OR WILL IT????

It's not just the Catholics who have voiced this condemnation of the "abortifacient" properties of birth control.  The Evangelicals who fill the ranks of the pro-choice movement are similarly quick to criticize any use of "unnatural" hormonal contraceptives.  There is the outstanding example of the Duggar family, who believe that their use of the Pill caused the miscarriage of one of their pregnancies back in the '80s, and have spent the past two decades atoning for this crime by pushing the limits of human reproductive capacity.  Just a quick Google search will yield a bevy of emotionally-charged, poorly-researched, and often blatantly deceptive websites devoted to defaming all birth control use and equating contraceptives with murder.  (Notable examples including Birth Control is a Sin, Birth Control Causes Abortions, AbortionFacts.com, and perhaps most horrifying, PoisonedByThePill).  A common thread throughout these websites is that of deliberate deception at the hands of doctors and pharmacists.   Readers are urged to "read the fine print" and "wake up" - as if the entire medical profession were aligned in some giant conspiracy to kill Evangelical embryos for the good of Science and Atheism and Richard Dawkins.

From this movement has grown a plethora of misconceptions and taboos about the "Morning After Pill" and oral contraceptives.  Many women worldwide are misinformed about emergency contraception and its mechanism of action:  some actually mistake the Plan B pill with RU486, the "abortion pill."  Pro-life lobbying on this issue has also spawned “the Pharmacist’s Conscience Clause,” a provision which allows a pharmacist to withhold oral contraceptives and the "morning after pill” on moral grounds. A recent study estimated that 6% of American pharmacists actually withhold contraception - which probably makes it pretty difficult to purchase birth control in Kansas.  This poor understanding of emergency contraception deters many genuinely well-meaning women and couples from choosing Plan B following unprotected intercourse - which, of course, is the intended effect of the religious fear-mongering. 

Now, Pope Paul VI was not a doctor or a biologist, so I was interested in how he arrived at his understanding of the mechanism of action of birth control pills and emergency contraception.  So I popped on over to PubMed to see what relevant (and unbiased) information medical researchers had discovered on the topic.

But first, a little background on early embryonic development: the human embryo typically implants in the uterine wall at the blastocyst stage, approximately one week after fertilization, when it consists of 32 cells.  To prevent a subsequent pregnancy, the ovaries begin secreting progesterone, a hormone which inhibits further ovulation.  Progesterone also inhibits the process of sperm capacitation, which enables a sperm to fertilize an egg.  In addition, this hormone thins the lining of the endometrium - just like it does during the luteal phase, i.e. a menstrual period.

Both oral contraceptives and older versions of the Plan B pill (which is essentially a higher dose of the same thing) rely on progestrin, a synthetic form of progesterone, essentially to trick the body into believing that it is already pregnant.  Thus, ovulation and sperm capacitation do not occur, and the endometrial lining thins.  It is this capacity of progesterone which has conservatives jumping down throats and splitting hairs about what constitutes prevention vs. termination of pregnancy, and losing sleep over the fate of the human blastocyst.

http://www.glowm.com/?p=glowm.cml/section_view&articleid=2&SESSID=evpji2lnn7ah65gbjah4bgnc40

So let's see what a few decades of medical research have to say on the matter.  First, newer Levonorgestrel-based contraceptives (such as Plan B One-Step) can apparently only prevent ovulation, and cannot prevent pregnancy once ovulation has occurred.  No studies indicate that Levonorgestrel has any "abortifacient" capabilities.  Thus, Levonorgestrel is only 80% effective at preventing pregnancy.  The results of studies on progesterone-based pills are a little bit hazier:  some report "with mild confidence" that progesterone prevents implantation, while others deny this to be the case.  Most review articles state that the prevention of implantation is "possible in theory," but do not provide relevant statistics.  In contrast, the post-coital insertion of an IUD has been shown to prevent implantation of an embryo; Mifepristone, the "abortion pill," can be taken in small doses to produce the same effect.

The general medical consensus:  certain forms of emergency contraception (Mifepristone and IUDs) have the secondary effect of preventing embryonic implantation.  However, the most commonly-used form of emergency contraception (Levonorgestrel), does not act in this way.  In regards to the Pill, it is possible in theory that these contraceptives prevent the implantation of a fertilized embryo, but no study to date has strongly indicated that this is the case.  I speculate that the findings of such studies are complicated by the fact that, even in the absence of birth control, at least half of fertilized human ova do not successfully implant.  Here's a little graph I threw together about the prevalence possible fetal fates in the U.S.:

Needless to say, these stats are going to make Georgia Rep. Bobby Franklin's job very difficult if he in fact intends to investigate and press charges for every miscarriage that occurs in his state.  The majority of fertilized oocytes to not make it to be full-fledged humans, even without medical or chemical interventions.  Ultimately, it is difficult to determine how often emergency contraception prevents an embryo from implanting when God Himself is already doing such a good job of it.

Globally Pro-Choice

Last week, I was walking across Georgetown's campus when I was stopped by an acquaintance and asked if I would give a minute for "Global Health Day."  Behind her, a large banner proclaimed "Half the world lives on less than $3 a day... that is what we spend on a cup of coffee."  After filling me in on several additional depressing statistics regarding starvation, malaria, and infant mortality, this well-meaning girl asked if I would help global health awareness by writing down something that I believed everyone in the world deserved.  Without pausing, I wrote "access to birth control."

My response was met at first with a smirk, then with irritation, as she suggested that I write something else. "Please take this seriously," she pleaded, implying that my answer had deliberately mocked the plight of millions of starving children worldwide.  It was as if I had suggested sending vibrating cock rings and flavored lube to the war-torn Congo.

http://www.foogle.biz/starving_world/starving.htm

Poverty and global health are issues that we love to talk about.  Starving children in China/Africa/Southeast Asia are eternally the subjects of guilt-tripping rhetoric.  Droves of celebrities and well-meaning high schoolers descend on developing nations each year, all seeking to "combat hunger" and "fight AIDS" in fairly non-specific ways.  Images of barefoot toddlers crying in the muddy streets of Delhi and Lima rouse us to donate to a myriad of international charities.  Yet in all of this discussion of child poverty, there is no mention of the children themselves being a compounding factor.

The correlation between high fertility rates, poverty, and low life expectancy is well established.  According to the UN TFR Ranking (2009), the top twenty nations in terms of fertility rate per woman include Niger, Yemen, Somalia, and Afghanistan; each of these countries has a fertility rate more than three times that of the U.S. and Western Europe.  The UN TFR has also provided this helpful visualization of average fertility rates worldwide:

http://en.wikipedia.org/wiki/Fertility_rate

Anyone who has taken a class in logic knows that correlation does not imply causation.  With a little imagination, though, it's not difficult to picture how a rapidly growing population coupled with a finite number of resources keeps literacy rates low and poverty rates high, fuels political unrest, and greatly facilitates the spread of disease.  And that's not even touching the impact on the women who are actually bearing these children.

http://www.glpinc.org/Web_pages/Illiteracy_Globally.html

Unfortunately, the international community is unlikely to embrace worldwide family planning measures any time soon.  For one thing, one of the world's most powerful men, Benedict XVI, would not approve.  A large number of charities aimed at alleviating poverty are religiously affiliated, and these groups prefer to combat world hunger by collecting canned food, building new churches, and praying.  Contraception, of course, is not in the Catholic or Evangelical vocabulary.  This view has played no small role in the House's recent defunding of the United Nations Population Fund.

It's not just the right wing that's to blame, however.  Even liberal and pro-choice groups shirk from advocating contraceptive use abroad, less they be accused of promoting eugenics or forcing Western practices and culture upon the developing world.  Additionally, the realm of international charity seeks to project itself as bipartisan, eschewing controversial issues such as contraception.  Food, water, health, and education are all hot topics of conversation, but one of the best long-term solutions remains, for now, grossly overlooked.

At the end of the day, it's touching and inspiring to see a a picture of volunteers building a school abroad or serving food to little brown children.  It's very difficult to evoke the same feelings with a picture of a couple using a condom.