Abortion – Population Matters-USA

Well, the answer to the title’s question is “yes, no and maybe”.

First, I should define a “reproductive health desert”. It is an area without a provider of reproductive health. Thus, there are maternity, fertility, contraceptive and abortion deserts.

Cortez (Montezuma County) was a maternity desert for a brief period of time. The hospital’s administration closed down their birthing center. Outrage from the community pressured the management to open it up again.

There were a few years that we had sophisticated infertility services in Durango. Unfortunately, the two doctors who provided this care are gone. The OB-GYN doctors who remain can help couples with most fertility issues, but some folks will need to go to Albuquerque or elsewhere for more complex infertility problems.

There shouldn’t be a real shortage of effective contraception anywhere in the US now that OPill® is available to anyone with a uterus. Or without—I got a package of this over-the-counter birth control pill for an art project from Amazon. They didn’t quibble over my gender.

(More about Opill®: It is a birth control pill that is available without a prescription. The only contraindications are pregnancy or a history of breast cancer. It needs to be taken every day at the same time.)

However, there are women who don’t want to use hormones or aren’t regular in taking pills or cannot afford $20 a month. They may live in a county without a clinic that provides the full range of family planning methods—this is how “contraceptive desert” may be defined, and almost 20 million women live in counties that lack this care.

La Plata County is far from a contraceptive desert. Even though Planned Parenthood is closed, the health department (in the beautiful AXIS Health System building), many physicians, and midlevel providers are happy to prescribe desired methods.

Unfortunately, we do live in an abortion desert now that PP is closed. PP clinics in neighboring Cortez and Farmington do provide medication abortion care, however they are limited to 11 weeks gestational age. Regrettably, procedural abortions (those done in the clinic) are not available in the Four Corners area at this time.

While on the subject of abortion, I just read a reason that the religious right has chosen to fight against this important part of healthcare. It was written by a Methodist pastor, David Barnhart.

‘“The unborn” are a convenient group of people to advocate for. They never make demands of you; they are morally uncomplicated, unlike the incarcerated, addicted, or the chronically poor; they don’t resent your condescension or complain that you are not politically correct; unlike widows, they don’t ask you to question patriarchy; unlike orphans, they don’t need money, education, or childcare; unlike aliens, they don’t bring all that racial, cultural, and religious baggage that you dislike; they allow you to feel good about yourself without any work at creating or maintaining relationships; and when they are born, you can forget about them, because they cease to be unborn….

‘It’s almost as if, by being born, they have died to you. You can love the unborn and advocate for them without substantially challenging your own wealth, power, or privilege, without re-imagining social structures, apologizing, or making reparations to anyone. They are, in short, the perfect people to love if you want to claim you love Jesus but actually dislike people who breathe.

‘Prisoners? Immigrants? The sick? The poor? Widows? Orphans? All the groups that are specifically mentioned in the Bible? They all get thrown under the bus for the unborn.”

A small group of concerned people are working to bring back both medical and procedural abortion services to Durango, but it may take months.

The really bad news is that we have elected a misogynistic felon with a narcissistic personality disorder. Even worse news is that people have fallen for Trump’s lies.

There’s some good news, despite lots of disappointments. In my state, Colorado, almost 2/3rds of voters chose to amend our constitution to guarantee the right to safe abortion care. In addition, the state will start paying for abortions for women who are state and local government employees, and for those on Medicaid.

The state to our north, Wyoming, had abortion laws preventing almost all abortions. In November, a Wyoming judge ruled that the laws were against that state’s constitution. She wrote: “The abortion statutes suspend a woman’s right to make her own health care decisions during the entire term of a pregnancy and are not reasonable or necessary to protect the health and general welfare of the people.” Although the state will probably appeal this decision, for now women can obtain safe, legal abortion care in Wyoming.

Public health scientists have identified several causes why young children don’t flourish. Children may not do well if pregnancies are too close together. We also know that if a mother really, really doesn’t want to carry a pregnancy, but is forced to give birth, that the child may not fare well. Do children who result from unintended pregnancies also suffer?

“Yes” is the sad answer. Researchers looked at Demographic and Health Surveys from developing countries. Surveyed mothers rated their births as being desired, mistimed or unwanted. The endpoint of the research was infant mortality—the death of the child before age one year of age. What they found is that children whose pregnancies were described as unwanted or mistimed were more likely to die. This finding held for 41 of the 60 countries studied. Moreover, the effect was stronger in poorer, less educated places.

Unfortunately, there are over 120 million unintended pregnancies globally each year. These findings are the bad news. The good news is that now there is proof that contraception decreases infant mortality in impoverished areas.

Unfortunately, there is concerning news about two of the Long-Acting Reversible Contraceptive (LARC) methods. DepoProvera, has been associated with an increased risk of users developing meningiomas. These are benign tumors of the membranes covering the brain. Meningiomas are more common in women, and have been found to have receptors that respond to female hormones. However, the risk of developing a meningioma is very, very small, and it is still very small for users of Depo.

There are four IUDs containing a hormone. In addition to providing excellent contraception, they make periods less painful and lighter. Fortunately, they don’t seem to increase the risk of meningioma, but the latest information is that they may increase the risk of breast cancer.

It will take more studies to confirm (or refute) these concerns about LARCs causing tumors. In the meantime, it is the right of women to know of these possibilities. However, the risks of morbidity or mortality from pregnancy exceed by far the likelihood of a problem caused by any contraceptive method, if used properly. For women who desire long-term reversible birth control, the ParagardÒ IUD is a hormone-free LARC. It can provide excellent protection for 10 years—or possibly even longer.

Since the Dobbs decision, many states have made it very difficult to access safe abortion care. Furthermore, unintended pregnancies cause problems if the mother is forced to carry to term. Taken together, these facts make it all the more important to increase the availability of contraception.