Unintended Pregnancy: A Biomarker for Disease and Poverty

The U.S. Catholic Conference of Bishops proved in its late Friday statement opposing President Obama’s compromise plan on contraceptive services that it cares as little about science as it does about women’s health. “All the other mandated ‘preventive services’ prevent disease, and pregnancy is not a disease (emphasis in the original),” the Bishops’ statement said.

The U.S. Catholic Conference of Bishops proved in its late Friday statement opposing President Obama’s compromise plan on contraceptive services that it cares as little about science as it does about women’s health. “All the other mandated ‘preventive services’ prevent disease, and pregnancy is not a disease (emphasis in the original),” the Bishops’ statement said.

Wrong. Pregnancy obviously isn’t a disease, but there are very distinct, measurable and negative consequences for the health and well-being of the mothers and children that result from unwanted pregnancies. “Births resulting from unintended or closely spaced pregnancies are associated with adverse maternal and child health outcomes, such as delayed prenatal care, premature birth and negative physical and mental health effects for children,” the Guttmacher Institute reports on its fact sheet on the issue.

Further, in what ought to be of some interest to abortion opponents, unintended pregnancies heighten the risk of abortion.  Nearly half of all pregnancies in the U.S. each year are unplanned, and over 5 percent of American women of child-bearing age (18 to 44) have unintended pregnancies every year — one of the highest rates in the industrialized world.  Yet 42 percent of those pregnancies end in abortion. Moreover, the rates of unintended pregnancy are significantly higher for poor and minority women, where the lifelong consequences of poor maternal and child health make escaping poverty that much more difficult.

So saying “pregnancy is not a disease” entirely misses the point. Contraception prevents unwanted pregnancies, which may not be a disease, but are definitely a biomarker of disease.

As a thought experiment, let’s apply the bishops’ logic to the other prevention services with which they have no quarrel. Would they oppose paying for pills that lower cholesterol? Nobody ever died from elevated cholesterol. It is a biomarker that can lead to clogged arteries, which can cause heart attacks and strokes, sometimes fatal. But cholesterol itself?

How about programs to promote quitting smoking? Everyone knows that cigarettes “cause” lung cancer. But in fact we only know that from epidemiological studies that have shown an association between the activity — smoking — and the outcome — cancer.

There is sound epidemiological evidence showing that unwanted pregnancies lead to worse health outcomes. Contraception prevents unwanted pregnancies. That’s why every health insurers should provide coverage for contraception as part of its suite of highly-rated preventive services at no cost to plan beneficiaries. The president said organizations with religious or moral objections to the use of contraception don’t have to pay for it. That policy should have been satisfactory — unless the bishops’ real goal was to impose their morality on everyone else.