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The New York Times



May 7, 2006

Contra-Contraception

By RUSSELL SHORTO

The English writer Daniel Defoe is best remembered today for creating the ultimate escapist fantasy, "Robinson Crusoe," but in 1727 he sent the British public into a scandalous fit with the publication of a nonfiction work called "Conjugal Lewdness: or, Matrimonial Whoredom." After apparently being asked to tone down the title for a subsequent edition, Defoe came up with a new one — "A Treatise Concerning the Use and Abuse of the Marriage Bed" — that only put a finer point on things. The book wasn't a tease, however. It was a moralizing lecture. After the wanton years that followed the restoration of the monarchy, a time when both theaters and brothels multiplied, social conservatism rooted itself in the English bosom. Self-appointed Christian morality police roamed the land, bent on restricting not only homosexuality and prostitution but also what went on between husbands and wives.

The wheels of history have a tendency to roll back over the same ground. For the past 33 years — since, as they see it, the wanton era of the 1960's culminated in the Supreme Court's Roe v. Wade decision in 1973 — American social conservatives have been on an unyielding campaign against abortion. But recently, as the conservative tide has continued to swell, this campaign has taken on a broader scope. Its true beginning point may not be Roe but Griswold v. Connecticut, the 1965 case that had the effect of legalizing contraception. "We see a direct connection between the practice of contraception and the practice of abortion," says Judie Brown, president of the American Life League, an organization that has battled abortion for 27 years but that, like others, now has a larger mission. "The mind-set that invites a couple to use contraception is an antichild mind-set," she told me. "We oppose all forms of contraception."

It may be news to many people that contraception as a matter of right and public health is no longer a given, but politicians and those in the public health profession know it well. "The linking of abortion and contraception is indicative of a larger agenda, which is putting sex back into the box, as something that happens only within marriage," says William Smith, vice president for public policy for the Sexuality Information and Education Council of the United States. The Guttmacher Institute, which like Siecus has been an advocate for birth control and sex education for decades, has also felt the shift. "Ten years ago the fight was all about abortion," says Cynthia Dailard, a senior public-policy associate at Guttmacher. "Increasingly, they have moved to attack and denigrate contraception. For those of us who work in the public health field, and respect longstanding public health principles — that condoms reduce S.T.D.'s, that contraception is the most effective way to help people avoid unintended pregnancy — it's extremely disheartening to think we may be set back decades."

Why is this happening? What's the nature of the opposition to something that has become so basic a part of modern life?

One starting point is the Catholic Church, and especially Pope John Paul II, whose personal and philosophical magnetism revitalized Catholics around the world, especially the young. A series of reflections the pope gave between 1979 and 1984 on the "theology of the body" — his vision of the integrated physical, mental and spiritual human — has become a whole method of study within the church. Bishop John W. Yanta of the Diocese of Amarillo, Tex., who oversees an organization founded last year to train priests in the "Gospel of Life," has called contraception "intrinsically evil" and "a big part of the culture of death."

Some Protestants have come to a similar view recently. President of the Southern Baptist Theological Seminary: "I cannot imagine any development in human history, after the Fall, that has had a greater impact on human beings than the pill," Mohler continues, "I think there could be no question that the pill gave incredible license to everything from adultery and affairs to premarital sex and within marriage to a separation of the sex act and procreation."

Democrats, meanwhile, have had their difficulty with the abortion issue, and their new hopes are pinned to a strategy that focuses on contraception as a way to reduce unintended pregnancy. Last month, Senators Harry Reid and Hillary Clinton — an anti-abortion Democrat and an abortion rights Democrat — introduced legislation that would require insurance companies to cover contraceptives. In part, the idea is to force Republicans to support contraception or be branded as reactionaries. An editorial in the conservative magazine Human Events characterized the effect of such legislation as "enabling more low-income women to have consequence-free sex."

All parents struggle with how to shield their children from the excesses of popular culture, and not surprisingly, surveys show that most want teenagers to delay first intercourse. But by wide margins they also say kids should be taught about contraceptives. A poll released in 2004 by National Public Radio, the Kaiser Family Foundation and Harvard's Kennedy School of Government found, for example, that 95 percent of parents think that schools should encourage teenagers to wait until they are older to have sex, and also that 94 percent think that kids should learn about birth control in school.

Abstinence has also become a primary element of Pepfar, President Bush's overseas AIDS relief program — with, some experts say, disastrous results. The Government Accountability Office released a study in April that found that in many countries administrators were forced to cut funds intended to fight mother-to-child H.I.V. infection in order to finance abstinence programs.

Social conservatives in the U.S. seem to be moving in the opposite direction from much of the rest of the world. At least 12 countries have liberalized abortion laws in recent years. Emergency contraception is currently available without a prescription in more than 40 countries. In much of Western Europe, abortion and contraception are available and fully covered by insurance.

The Netherlands, where the teen pregnancy rate also ranks among the lowest in the world, has long been of interest to sex educators in the U.S. for the frankness of its approach. The national sex education course, called Long Live Love, begins at age 13. One of its hallmarks has been dubbed "Double Dutch" — encouraging the use of both condoms and birth control pills. "It's proven successful," says Margo Mulder of STI AIDS Netherlands, the Dutch health education center. "It shows that when you discuss contraception and protection with students, they actually are careful. And I know that some people in the U.S. say that when you promote contraception, you're also promoting sex, but we've found that when you educate people, they don't have sex earlier. They think about it. So you're not promoting sex, you're helping them to be rational about doing it."

While Americans as a whole don't hold such a dark view of comprehensive sex education, many do feel there's something wrong with a strictly clinical approach. This ambivalence, according to Sarah Brown of the National Campaign to Prevent Teen Pregnancy, gets to the root of the problem and may explain the numbers. "One of the things I'm most often asked is why the abortion and unintended pregnancy rates are so much lower in Europe," she says. "People talk about the easy access to contraception there, but I think it's really a matter of the underlying social norms. In Europe, these things are in the open, and the only issue is to be careful. Here in the U.S., people are still arguing about whether it's O.K. to have sex."

Russell Shorto, a contributing writer, has written for the magazine about the anti-gay-marriage movement and religion in the workplace.