The Shocking Ethics Behind the Contraceptive Choice Project

A study was released last week that claims to show that giving women free contraception drastically reduces unplanned pregnancy rates, and therefore abortion rates. The results are based on the Contraceptive Choice Project, in which researchers from the Washington School of Medicine offered over 9,000 women in St. Louis (some as young as 14) free contraception of their choosing. The story is making the rounds among many of the big media outlets, often cited as a triumph for the ideas behind the Health and Human Services mandate. The Huffington Post writes:

The findings of the study are significant at a time when a number of conservatives in politics and public policy are pushing back against the Obama administration's contraception mandate under the Affordable Care Act, which requires most employers and insurers to cover birth control at no cost to women. Moreover, a number of states have voted to defund Planned Parenthood -- one of the nation's leading providers of contraception to low-income and uninsured women -- because some of the organization's clinics also offer abortions.

"I would think if you were against abortions, you would be 100 percent for contraception access," Dr. James T. Breeden, president of the American College of Obstetricians and Gynecologists, said of the results.

The overall take seems to be: If everyone would just support the Obama administration's plan for health care, what happened to the women of St. Louis could happen to women everywhere!

I think they might be right. And we should all be terrified by that thought.

In this study, the vast majority of the women chose implantable methods of contraception like intrauterine devices and under-the-skin implants, which were explained to them as being most reliable for preventing pregnancy. Normally these procedures are significantly more expensive than other forms of contraception, but when they were offered for free, women agreed to have them done. This seems to be exactly what the researchers and their supporters hoped would happen: Because these forms of contraception involve invasive procedures that lead to semi-permanent sterilization, they led to a reduction in unintended pregnancies (or at least fewer implantations of new life that has been conceived). Therefore, the thinking goes, the study was a raging success. Fewer pregnancies equals a successful outcome -- in all the coverage of this story, that assumption is never questioned. But when you take a closer look at this project, and the environment in which it took place, you see that it may not be "successful" at all for the women who were recruited to participate in it. In fact, the ethics behind the entire study shock the conscience.

According to the local Planned Parenthood website, "currently, St. Louis has top rankings in chlamydia and gonorrhea, and is number five in the nation for syphilis and HIV." It's also number six in the Center for Disease Control's list of the top 15 cities with the worst herpes rates. The St. Louis Children's hospital reports that their city "has some the highest rates for sexually transmitted infections when compared to other U.S. cities." The Gonorrhea rates in St. Louis are seven times the national average; chlamydia rates are four times the national average; and syphilis rates are three times the national average.

The researchers behind the Contraceptive Choice Project specifically recruited women who were low-income, from minority ethnic groups (the word minority appears in the study abstract 13 times), and had a history of STDs. And, though they knew that these at-risk women were living in an area where STDs are almost epidemic, the researchers' primary concern was rendering them infertile.

By the study's own admission, barrier methods of contraception are ineffective; that's why, to prevent pregnancy, they were pushing the more invasive techniques that shut down a woman's reproductive system for the long term. And so, despite one passing mention of the women in the study receiving information about STDs, even the study authors could not honestly say that they weren't aware that they were drastically increasing these women's risks of contracting diseases. If people aren't using condoms faithfully and effectively under normal circumstances, certainly the results would be even more abysmal if they'd been rendered infertile. Not that handing out condoms is ever really an effective solution, but even within their own paradigm these researchers would have to admit that most of the participants in their study were now at higher risk for contracting sexually transmitted diseases.

In 2010, during the time of the study, the city of St. Louis saw "a 46 percent jump in syphilis, a 31 percent rise in gonorrhea and a 3 percent increase in chlamydia." Nobody knows whether the Contraceptive Choice Project had anything to do with these startling numbers; the director of the local Health Department wrote it off as an increase in reporting. But, in any case, what is certain is that there has been little concern over these figures in the media coverage of the "success" of this study.

The study authors, as well as the media outlets who have championed this project, show a laser-like focus on reducing the fertility rates of women, particularly those who are poor and minorities -- even at the expense of their overall health. Given the powerful control that these invasive contraceptive measures exert over a woman's body, I wouldn't be surprised if this program of free IUDs and under-the-skin implants did lead to fewer pregnancies as compared to other methods of contraception. But, if that's the only goal, wouldn't permanent surgical sterilization be even more effective? Perhaps full hysterectomies, just to be safe? The slope that we have begun sliding down is a dangerous one, and leads to a terrible, ugly place.

The New York Times coverage of the Contraceptive Choice Project noted that "women’s health specialists said the study foreshadows the potential impact of the new health care law." Indeed it does. And women have now been given a glimpse of a system which has zero interest in their wellbeing, and sees them only as breeding machines to be kept under control.