In a July 18 New York Times op-ed , Dr. Vanessa Collins, a physician and vice-president of medical affairs for Planned Parenthood Federation of America offers an interesting but erroneous argument for mandating insurance coverage of contraceptives as preventive medicine.
First of all, preventive medicine implies the prevention of a pathological condition. Pregnancy is anything but pathological. Artificial contraception is an elective medical therapy for those desiring to block a totally normal and healthy physical condition. Not only is contraception elective, but the decision to have sex should be elective as well. Is Dr. Collins suggesting that women do not have a choice when it comes to sex? That is truly a misogynistic position.
Secondly, by using her own unmarried daughter as an example of the archetypal patient using contraception, Dr. Collins implies that sexual activity is unconnected to relationship status. If an unmarried woman makes the conscious decision to be sexually active, it seems she should also bear the consequences of such a decision. Her partner should be willing to share any burdens of the relationship, including the financial cost of sexual relations. If a woman is not in a stable relationship, it seems unreasonable to demand someone else has to pay for her sexual dalliances.
Finally, it is extremely unfair for Dr. Collins to cite the health risks of unintended pregnancies without also citing the serious health risks of artificial contraception. The risks of using an IUD include life-threatening infections and pelvic inflammatory disease that can lead to subsequent infertility. Oral contraceptives are associated with blood clots, strokes, and increased risk for certain cancers including breast cancer, cervical cancer, and liver cancer. These risks are outlined by the National Institutes of Health fact sheet on oral contraceptives and cancer risk. They are most pronounced when oral contraceptives are started in a girl’s teens-the very population that Dr. Collins asserts needs contraceptives the most.
Sexual activity is elective. Preventing the normal consequence of sexual activity, pregnancy, is elective. The use of artificial contraception to prevent pregnancy is a personal lifestyle choice, not a medically recommended therapy. Therefore, artificial contraception should not be considered mandated preventive medical care. In these tight fiscal times, we cannot afford to be too inclusive with what constitutes preventive medicine.
Denise J. Hunnell, MD, is a retired Air Force Major and Fellow with HLI America , an educational initiative of Human Life International.