Sex and babies and ECs, oh my!

note: I’m taking a break from my usual posts about Warcraft and other frivolities to offer some Social Commentary. Proceed with caution.

I saw a blog post the other day that bothered me. I wouldn’t comment on it, but over the last year I have actually seen more than one post/article along the same lines, and feel obliged to put some thoughts down in writing. I won’t link to the blog post that prompted me to write, because I want to avoid picking on a particular person here.

What has been bothering me are posts and essays–I’ve seen at least three recently along these lines–that describe a situation in the poster’s life like this:

a) Poster has sex, during which birth control fails, making pregnancy a possibility.

b) Poster has a reason for not wanting a pregnancy. This ranges from having a medical condition that would make pregnancy difficult, to simply not wanting to be inconvenienced by a pregnancy.

c) It’s the weekend or late at night, so poster goes through the local phonebook calling pharmacies looking for a physician to provide her with emergency contraceptives. She is unable to find anyone who, after learning that she was not raped, is willing to do so.

d) Unable to find a physician without moral qualms about said contraceptives, the poster feels like she’s being judged and punished for having sex outside of wedlock.

e) She posts angrily on her blog, citing her difficulty in attaining emergency contraceptives (hereafter ECs) as evidence that the woman-hating conservative fascist theocracy is finally upon us. Outrage at this latest blow against personal freedom spreads across the internet.

The first thing that strikes me as I read this story is this: people seem to have forgotten that pregnancy is a natural, intended result of sex. Whatever other benefits it may have, its main basic purpose is to produce babies. Yet this does not seem to stop people from engaging in sexual activity and then being totally taken aback when pregnancy results. I realize that they were using birth control, and it failed; but I’m pretty sure that most everybody knows that birth control is hardly guaranteed to work 100% of the time. Hey, I know that, and I’m a prudish reformed conservative male; certainly enlightened liberal feminists know it too.

Why am I babbling about a highly personal subject like this? Because it bothers me that somebody who really doesn’t want to get pregnant–whether for medical reasons or personal whim–is engaging in sexual activity with only the mildest thought apparently given to the possibility of pregnancy. Different types of birth control have varying rates of success; and there are medical procedures you can undergo to reduce or eliminate the chance of pregnancy if you are unable or unwilling to go through a pregnancy. But instead of taking advantage of these, the couple in question decided to have sex with a prone-to-failure method of birth control and then expect society to provide them with a way to fix things after the fact when–surprise–sex results in pregnancy.

The problem with relying on society to get you out of your little fix is, of course, that a large chunk of society considers the sorts of ECs sought by this person to be uncomfortably close to abortion. (And yes, I’m aware that there’s a big moral gray area between abortion and different types of contraceptive; but people are within their rights to hold their own convictions.) But in our story above, the poster finds it completely unreasonable that a doctor would have moral qualms about prescribing an EC on short notice to a random person. Society has no right to restrict a woman’s reproductive rights in any way or tell her what to do with her body, the argument goes–but the same society should force doctors to violate their consciences and prescribe medical supplies they find morally troublesome, all because somebody wanted to have sex without taking adequate steps to deal with the (very predictable) consequences.

It is often suggested by certain feminist and pro-choice activists that American women live under big restrictions on their reproductive rights. Stories like the one above are cited as evidence that American society unfairly limits the choices available to women who seek control over their own sexuality–hasn’t society, by not making ECs readily available to this person, denied her the right to choose whether or not to have a baby? I have never really understood this line of reasoning, because it seems to me that Americans have an absolutely enormous amount of sexual and reproductive freedom. You can have sex with anyone you want, however you want, using whatever form of birth control you want. When you get to the point of calling around at midnight trying to find a pharmacist who will give you ECs because your birth control failed, you have already made a whole lot of free, unhindered choices. At that point, you’re not asking for the right to choose–you’re just asking society to sweep away the results of your earlier choices.

I probably sound quite unsympathetic to this couple. The truth is, I’d be willing to lend societal help to a pregnant woman in a truly difficult situation–rape, extreme poverty, dire medical conditions, a clear inability to provide for a child–even if it meant compromising a bit on my generally pro-life beliefs. Some people really are trapped by life circumstances and are denied the ability to make choices about their future. But if you have the freedom and opportunity to avert pregnancy and simply choose not to do so, don’t expect anyone to violate their conscience to save you from the consequences of your own choices. You’ve lost the moral high ground.

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10 thoughts on “Sex and babies and ECs, oh my!

  1. kim

    You make some interesting points, some I agree with and some I don’t (especially that line about being “inconvenienced” by pregnancy – clearly only a man would say that 🙂 and I’m going to address some tangential issues inspired by your post on my blog.

  2. Andy

    Kim, thanks for your thoughtful reply. I’ll think it over and see if I have anything to say in response. As for the ‘inconvenienced’ line, that was perhaps over the line, but I actually did use the word deliberately–I know it seems like a crass way to put it, but that’s the impression I got from the account I read. That said, my use of the word was needlessly inflammatory and I probably shouldn’t have used it.

  3. Brit

    I assume you’re talking about this case?
    http://www.boingboing.net/2006/09/22/what_getting_emergen.html
    I had a couple thoughts:
    Andy:

    “citing her difficulty in attaining emergency contraceptives (hereafter ECs) as evidence that the woman-hating conservative fascist theocracy is finally upon us. Outrage at this latest blow against personal freedom spreads across the internet.”

    Actually, she never said, “woman-hating conservative fascist theocracy is finally upon us”, I thought that little bit was unncecessarily added to make her look crazy and establish sympathy for people not willing to give her EC. It’s a rhetorical strategy to bias the reader against her viewpoint.
    Andy:

    “When you get to the point of calling around at midnight trying to find a pharmacist who will give you ECs because your birth control failed”

    Actually, she called the next day. Quote from her blog:

    “Friday night the condom broke. But I didn’t panic, I thought to myself, with a huge sigh of relief, “Wow, thank goodness it’s over the counter now!” and I fell asleep (since there are absolutely NO 24 hour pharmacies within 100 miles of me). Saturday morning I awoke and phoned the pharmacy.”

    Andy:

    and then expect society to provide them with a way to fix things after the fact when–surprise–sex results in pregnancy.

    She wasn’t asking “society” to “fix” anything. She was asking medical doctors and pharmacists to sign a prescription, for which she would pay money, for a product that is legally available in the US. They chose, on moral grounds alone, not to approve her. (They didn’t ask any medical related questions to her; all of their questions involved her marital status and whether the sex was forced.)
    Andy:

    But in our story above, the poster finds it completely unreasonable that a doctor would have moral qualms about prescribing an EC on short notice to a random person.

    I don’t think she objected to people having a position so much as the fact that no one at all would approve her. *Every* place that she could turn to denied her. Remember: these products have already been approved, and are available on the market. If society has a problem with EC, then they should attempt to ban it. But, now there are individual people standing in the way as gatekeepers to something that “society” has not banned. In this case, she happened to be surrounded by conservative people who wouldn’t approve her perscription for EC, but as a nation we have already approved EC by allowing it to be sold. Thus, it’s not so much an issue of “society not approving something” as it is the fact that conversative gatekeepers limiting her access to something that our larger society has already approved. (I can understand that some people have moral qualms about approving EC for women. In fact, I don’t want to force them to write these prescriptions. But, I do think that women should have someplace that they can go to to get EC. They shouldn’t be trapped into not getting EC simply because there happen to be a small number of people who can approve it, and all of them are unwilling to do so.) Quote from her blog:

    None of the hospitals in the surrounding counties would write it for me. I stopped my search at about 100 miles from my home because my telephone book wouldn’t take me out any further than that.

  4. kim

    I wasn’t sure if you were trying to be crass or inflammatory (as you said) with your word choice or if you just hadn’t spent enough time around huge and uncomfortable pregnant women. I haven’t read the writer you were thinking of when using the word ‘inconvenience,’ and I don’t want to ascribe any motives to your thinking, but I’ll explain a little about my reaction to that idea.
    When reading many pro-life writers, I get the sense that because of the seriousness of life and death matters and the overwhelming concern for a vulnerable fetus, the woman’s role in pregnancy is downplayed. Pregnancy is an enormous sacrifice for mothers – physically, mentally, emotionally, spiritually. Much of this sacrifice is bearable because having a baby is so joyful, but some of it is downright burdensome and agonizing (even for women who didn’t have complications like I did). It is so much more than an inconvenience – it is probably the most meaningful and difficult sacrifice we will ever make for another person.
    And while I think you’d agree that far too many women and men can be rather frivolous when it comes to getting pregnant (something like half of all pregnancies are unintended), I believe that most women do think seriously and deeply about their decisions once they become pregnant, even when they make choices that you and I think are wrong. To me, the language of inconvenience evokes images of women as lacking moral gravity and pregnancy as a walk in the park that don’t fit with the real life experiences of women I know.
    Sorry this comment is so long, but I’ve really enjoyed thinking over some of the issues your post has brought up.

  5. Andy

    Brit,
    Thanks much for the comments. You make some good points. Just a few quick responses:
    First, that is one of the blog posts that prompted my rant. Another was the WaPo article Kim noted in her response at her blog. That said, I was intentionally generalizing a bit.
    Secondly, the ‘fascist theocracy’ stuff is language she used first–read the followup post to her original EC post. She reflects on the experience and paints it in very stark “culture war” terms. I swear I didn’t make that up to make her look crazy. But yeah, it was snarky of me to include it, and if I could go back and rewrite my post I would not include it.
    Thirdly, I’ll try to explain my thoughts a bit more. I understand that she is upset that nobody would prescribe her the ECs she needed, and to a certain extent I sympathize with her. But I guess what it comes down to, in my view, is this: I view access to ECs and other morally-controversial, not-critical-for-survival medication as a privilege, not an inherent right. With that in mind, if people plan to rely on ECs as part of their system of birth control, then it is reasonable to expect those people to do research in advance and find out where and how to acquire them. Assuming that the local doctors share your ethical perspective on the medicine will a) set you up for an unpleasant surprise, and b) put you in the position of unfairly resenting the sector of society that won’t supply them to you. If this person’s experience is any indication, a very large chunk of the medical profession does not feel comfortable prescribing ECs–something that must be taken into account before you rely on them as your backup plan.
    Does that clarify things a bit? I am not trying to argue that ECs should not be legal or available, but because ECs fall outside the definition of “critical life-saving drugs,” it’s not reasonable for somebody who hasn’t done the research to expect her doctors to supply it. And it’s not reasonable to get outraged about it (again, read her follow-up post–she’s angry), because well, the whole situation was avoidable on a number of levels.

  6. Andy

    Kim:
    Ah, I understand what you are getting at. I will admit I hadn’t really thought about it from that angle, but yeah, upon reflection I agree that the language of ‘inconvenience’ is inappropriate, for the reasons you cite. It seems a bit ironic that pro-life writers (including myself), so concerned with taking pregnancy seriously, may actually end up trivializing it with poorly-worded assumptions.
    And yes, I have probably just not been around all that many pregnant women. Actually, one reason I don’t post about this topic (which I feel strongly about) more often is that I suspect it’s one of those things where you gain a whole new perspective on it once you’ve actually experienced it firsthand. (I ultimately decided to post my rant anyway because hey, it’s the internet…)
    Thanks again for your comments, guys.

  7. Brit

    Regarding the followup posts:

    Referring to a “small group” of people as “gatekeepers” is another rhetorical strategy.

    But they ARE gatekeepers. I don’t know what’s controversial about that characterization. This woman probably has tens of thousands of people living within a 100 mile radius, and only a handful of people who can permit her to access ECs. That is a gatekeeper. I’m not saying that they set themselves up as gatekeepers. I’m saying that because of the nature of medical practice, there ended up being only a few people she could go to for ECs, effectively making them gatekeepers. If all of those people had moral qualms about allowing her access to ECs, then they have prevented ALL possible access that she has to ECs.

    Hence, the law can’t be seen as restricting a doctor’s or pharmacist’s freedom of religion or conscience.

    And I said that I don’t believe doctors and pharmacists should be forced to prescribe ECs. But, I do think that people should have someone that they can go to.

    This is similar to a common misapprehension about what “censorship” is. Blockbuster not stocking x-rated videos is not “censorship,” but the federal government outlawing x-rated videos would be. Just because something is legal does not mean a private citizen—a dr. or a pharmacy or business owner–can be required to provide it to you. If it were, freedom of religion, of expression, and of conscience would be utterly meaningless.

    There is a difference between having a right to ECs and having a right to be angry about having to spend so much time trying to get ECs in an emergency and getting turned away at every attempt, discovering that everyone is simply too conservative to give it to you. That’s a terrible way to find out that you can’t get it. I said that should be at least one place that someone can go to to get ECs (whether that is planned parenthood or somewhere else). By the same token, I think there should be someplace where people can get contraceptives, too. I bring this up because there is a movement within the anti-abortion movement to ban contraceptives because they believe they promote a sexualized culture. I would be shocked if I lived in a small town and discovered that no one would sell contraceptives of any kind. No, I’m not arguing that doctors and pharmacists should be required to sell contraceptives, but I do think that people should have access to them (not as a “right” as you seem to think I am arguing, but rather, I don’t think a community should have zero access to contraceptives). Of course, with the contraceptives situation, people would tend to find this out at their leisure, rather than finding out during a potential emergency. It is rather chilling in an emergency situation to find out that no one will provide you with ECs.

    With that in mind, if people plan to rely on ECs as part of their system of birth control, then it is reasonable to expect those people to do research in advance and find out where and how to acquire them.

    I’m not sure that I agree with that for a couple reasons: First of all, I think it was reasonable for her to expect that someone somewhere would be willing to prescribe ECs for her. Second, since she spent hours calling around to hospitals for an EC prescription, it seems daunting to say that every woman who might need ECs should spend hours of their time calling to see how available ECs are just in case they need them. And even then, it ended up being an interview. Should all the women go through a pre-interview with the one doctor who sometimes prescribes ECs just to see whether or not they can get them in any particular situation that might crop-up? And third, a significant portion of her post was simply about the shock that no one would provide her with ECs. That shock would still be there even if she had discovered this by doing research beforehand, though it’s especially poignant in her particular emergency.
    In any case, it’s becoming a moot point since ECs are going to be available without a prescription, so women won’t have to jump through these kinds of hoops.

    Thus, there must be an awful lot of doctors and pharmacists who prescribe ECs around.

    And that statement just shows how reasonable it was for this woman to assume ECs would be available (a fact which weakens Andy’s point that “it is reasonable to expect those people to do research in advance” and supports my comment that “I think it was reasonable for her to expect that someone somewhere would be willing to prescribe ECs for her”). And while you are correct that it might be a fair assumption, it seems that it wasn’t a good assumption based on her actual experience. I think this is a situation that probably only happens in small conservative towns. In big cities, probably not so much.

    Not to pick on Brit, but he mentions “moral grounds” as if it were a mere preference, like pizza toppings.

    My use of “moral grounds” wasn’t to say it was an illegitimate preference. My point was that the doctors had the sole ability to write the prescriptions. They chose not to do so not on medical grounds, but on moral grounds. But, if they are making a moral choice, then why are they the only ones who can approve ECs? If approval or disapproval of prescribing ECs are simply a moral question, and not a medical one, then we shouldn’t have doctors being the only ones able to provide them. (I suppose the government agrees with me since ECs are going to be available without a prescription come 2007.)
    On a similar note, I read an article recently about taxicab drivers at an airport. At this one particular airport, all the taxicab drivers were Muslim, and because Islam has religious laws against alcohol, the taxicab drivers refused to carry a particular airline passenger because they were carrying two bottles of wine. Similarly, I don’t think Muslims should have to carry alcohol in their cars if they have religious problems against it. But, I think that having a few taxicabs around that would carry alcohol would remedy the situation. I don’t think airline passenger should have to choose between throwing their wine out or walking. And, to use Andy’s argument, I don’t think “it is reasonable to expect those people to do research in advance and find out” whether or not any of the taxicabs would allow wine in their cabs. It’s reasonable to assume that wine would not be a problem in most taxis. Further, you might argue that taxicabs should not be required to carry alcohol because “[i]f it were, freedom of religion, of expression, and of conscience would be utterly meaningless.” But, I’m not arguing that taxis should be forced to carry alcohol (just like I’m not arguing that doctors should be forced to prescibe ECs). Nor am I arguing that it is a “right” of passengers everywhere to carry alcohol in any taxicab they choose. I’m saying that people should have some option. (In this case, the airport should take some steps to provide some alcohol-carrying taxicabs so that taxicabs aren’t exclusively no-alcohol. In the case of ECs, I’m saying that something should be done somewhere – not even necessarily a government institution – to provide ECs so people aren’t caught in that sitaution. Unfortunately, that becomes a little more difficult because of the “doctors are the only one’s who can write prescriptions” clause of prescription medicine*.)
    BTW, I couldn’t find the article that I origially read about the Muslim-wine situation, but here’s a similar article:
    http://www.washingtontimes.com/national/20060930-010828-7244r.htm
    * Technically, I think some nurses or physicians assistants can also prescribe medicine, but that doesn’t really affect my argument.

  8. michele

    Brit, I love a good debate. Thanks for providing one!
    “‘Referring to a “small group” of people as “gatekeepers” is another rhetorical strategy.’
    But they ARE gatekeepers. I don’t know what’s controversial about that characterization.”
    get made a
    *Since I stated in my next sentence that they are indeed “gatekeepers,” in a sense, it’s certainly not controversial with me ☺. Except that using the term in reference to the fact that some drugs are not available without prescription, and that medical doctors are the ones who write prescriptions, has a definite tendentious feel to it.
    “‘Hence, the law can’t be seen as restricting a doctor’s or pharmacist’s freedom of religion or conscience.’
    And I said that I don’t believe doctors and pharmacists should be forced to prescribe ECs. But, I do think that people should have someone that they can go to.”
    *Well, there’s the rub. If we agree that drs etc. shouldn’t be forced to do something against their conscience, and if all drs etc. in a certain area find prescribing ECs to be unconscionable, then what do we do? In fact, it’s not clear that all dr.s in any particular area don’t prescribe them, but it is clear that it might take more effort to find one in some places than others. “Should” it be this way? If it shouldn’t, what exactly “should” be done about it?
    “There is a difference between having a right to ECs and having a right to be angry”
    *In my opinion, everyone has the right to feel any way they find themselves feeling about anything, any time. Nobody can or should try to tell someone else how they should feel about anything. The question is about whether an actual injustice has been done, not how anybody feels about the situation.
    “Second, since she spent hours calling around to hospitals for an EC prescription, it seems daunting to say that every woman who might need ECs should spend hours of their time calling to see how available ECs are just in case they need them.”
    *I disagree. Contraceptives or any other major aspect of a person’s health care are a big deal, and people should in fact take charge of their own health, and not just leave it on autopilot. Even if one does live somewhere where they’re assured of being able to find ECs or any other medical need they might have, one really should find a dr., keep up on medical checkups, and discuss one’s health plans with said dr.—including contraceptives–before an emergency makes it necessary.
    “And even then, it ended up being an interview. Should all the women go through a pre-interview with the one doctor who sometimes prescribes ECs just to see whether or not they can get them in any particular situation that might crop-up?”
    *That’s a good question. I certainly would strongly resent being asked such questions by some stranger somewhere. Which is why I would, once again, prefer to discuss the issue with my own doctor before I’m in a situation where I’m forced to be calling around to random doctors. On the other hand, if we agree that doctors have the right not to prescribe ECs or only in some circumstances, I don’t know any other way for them to exercise this right than to ask those questions.
    “‘Thus, there must be an awful lot of doctors and pharmacists who prescribe ECs around.’
    And that statement just shows how reasonable it was for this woman to assume ECs would be available”
    *I kind of disagree, again. “A lot of EC-prescribing drs around” doesn’t translate to “you can expect to hit one of them by randomly calling around during the few hours you have available before it’s too late” if one lives in an extremely conservative area. In fact, this isn’t such a great way of seeking any kind of medical treatment—I doubt there are many doctors willing to prescribe anything without seeing the patient first or knowing anything about their medical history. I can see there being no or almost no EC prescribers around in a very low-populated and conservative area. If one finds oneself in such an area, then, it’s not in fact reasonable to assume you’ll be able to get ECs on short notice, and it’s even more important for one to figure things out beforehand.
    I think there are two questions here: first, if we agree that people “should” be able to get a perfectly legal item, and that no one “should” be forced to provide it against their consciences, where does that leave us? Second, if I find myself possibly pregnant and unable to get ECs, who do I blame? Do I blame the doctors I called because they have different beliefs than mine? Do I blame hypothetical EC-prescribing doctors and clinics for not locating in my area, or not being available when I need them? Do I blame the “patriarchal establishment,” which, despite its ostensible stranglehold on the culture, has not managed to make ECs illegal or restrict doctors from prescribing them anywhere and any way they see fit? Or, despite being angry at the predicament I find myself in, do I accept at least some of the responsibility myself? I was the one who decided to participate in an activity that commonly leads to pregnancy, I decided to use a birth control method with a known failure rate (which they all have), I did not have a plan for what to do if that method failed. I can completely understand the frustration involved in finding oneself unexpectedly unable to get the help one needs, but at the same time I take peoples’ ability to practice their own moral code very seriously. Under the status quo, one is able to get ECs, but the fact that some people don’t believe in them is going to make it more difficult in some cases. I don’t know how to adjust the status quo in the favor of those who want ECs without damaging other peoples’ right to their own beliefs.

  9. Brit

    Hey. Just stopped by again to read responses. Didn’t really have any followup for you. Hope you’re both doing well.

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