Most Republican voters — 84 percent of them, according to a 2022 poll on behalf of the organization where I work — support safe and accessible birth control. But after Roe v. Wade was overturned last year, Republicans in Congress blocked legislation that would have enshrined a federal right to contraception. And it was Republicans who opposed requiring health insurance policies to cover birth control in the Patient Protection and Affordable Care Act of 2010.
The conservative position on birth control may be difficult for some political opponents to understand, but it’s not necessarily contradictory. At the heart of the issue is whether contraception is a positive right or a personal choice.
Conservatives generally see birth control as a matter of individual responsibility, and therefore a personal choice. That’s how I see it, certainly, and it’s why I want conservative leaders to promote policies making oral hormonal birth control widely available, including over the counter, and giving women a variety of birth control options. Combined with women and men making good choices when it comes to sex, this will, regardless of the legality of abortion, reduce demand for it — something everyone should want.
Indeed, many Americans who oppose abortion see preventive birth control as a tool to reduce the demand for it in the first place. This has become even more important in the last year, as the reversal of Roe v. Wade and corresponding changes to state laws have reduced the availability of abortions in some areas.
Independent Women’s Forum and Independent Women’s Voice, the two organizations for which I work, take no position on abortion. We surveyed likely Republican voters last summer and found strong support for birth control, with two-thirds of respondents describing themselves as pro-life believing that restricting contraception would increase abortions, and over 80 percent of them saying it is a pro-life position to support legal and accessible contraception in order to prevent abortions from even being considered.
But many conservatives would also say that it’s important to remember that an individual choice is just that — up to the individual. This means the individual is responsible for the choice. For birth control, it would entail paying out of pocket for the cost, which could be as low as $15 a month. It also means accepting the reality that if another person, such as an employer, doctor, nurse or pharmacist, doesn’t want to participate in your personal choice, he or she shouldn’t be made to do so.
Conservatives are also more likely to see birth control, in general, as an innovation that has had mixed effects on society. An overwhelming majority of American women have used birth control at some point, and 92 percent of Americans say it’s morally acceptable. Women have benefited from how contraception allows us to avoid unplanned pregnancy, space the timing of new children and treat medical conditions.
But despite its benefits to society, and particularly to women, widespread use of contraception has in my view come with a cost, facilitating a culture of cheap sex that has created mass confusion, pain and regret in the world of dating and family formation. This, along with the relatively high typical-use failure rates of the most traditionally popular forms of birth control, has disproportionately harmed women.
Women may have been, in some ways, the biggest winners of the pill-precipitated sexual revolution, but we have also been its biggest losers. Women are less likely to want casual sex but more likely to feel pressured into it and to experience negative feelings afterward. We might consider that even the mental health crisis may stem at least in part from casual sex or the lie of “sex without consequences.”
Understandably, some may find the idea that people will curb their sexual activities to be unrealistic. I was more sympathetic to this view before the Covid-19 pandemic, when millions of Americans changed their behavior significantly in response to a public health threat. If we could expect people to stay six feet apart, wear masks and not see loved ones for months on end, shouldn’t they also be able to avoid uncommitted, unprotected sex?
Pregnancy is not a disease, but people generally understand how to avoid making a baby. And they can understand that sexual promiscuity comes with other consequences — not just the risk of pregnancy, which contraception today can mitigate. Sex naturally bonds people, which can be emotionally costly and confusing without commitment. And having more partners before marriage has been associated with lower levels of marital satisfaction and stability and higher risk of divorce.
We have at least one example of reduced sexual activity in recent decades: teenagers. Teen pregnancy plummeted by 73.6 percent from 1990 to 2017, and while birth control played a part, the decline was also driven by a reduction in sexual activity. In 2019, only 9 percent of women who got abortions were under the age of 20, a smaller portion than in the past.
The reasons for decreased sexual activity among teenagers are not all good. For example, it could be that teenagers are spending far too much time online, instead of forming in-person relationships. But people across the political spectrum agreed that the high teen pregnancy rates of the 1990s were a problem — and for a good number of them, abstinence was at least part of the solution.
Just as there’s no such thing as sex without consequences, there’s no such thing as freedom without responsibility. Choices about sex — and birth control — are personal choices, and we are free to make choices, good and bad. But let’s strive for what’s good.
Hadley Heath Manning is vice president for policy at Independent Women’s Forum and Independent Women’s Voice.
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