Pregnancy Is not a Disease: How We Talk about the Female Body and the HHS Mandate

I should just make clear here at the beginning that my main interest in and objection to the HHS contraception mandate is that of religious liberty. If the Catholic Church and many Protestant believers did not have a moral objection to contraception and abortifacients, which they are now required by the federal government to provide to employees, this issue would have sailed right by me unnoticed. I simply think that the government encroaching on religious bodies by forcing communities to do that which they find morally reprehensible is wrong, regardless of whether or not I agree with the particular stance of those religious communities. The Amish should not be forced to buy televisions. An orthodox Jew should not be forced to provide my daughter with a baptismal gown. A Muslim woman should not be forced by the government to wear or not wear hijab. This so-called ‘compromise’ seems to do little to address the concerns of those most marginalized by this mandate. For reasons why see a helpful summary by my friend, Fr. John Baker, here.

But, putting all that aside, there is something else that has bothered me about this broad conversation regarding contraception and federal mandates:  The near constant refrain from those in support of the mandate that contraception is necessary for a woman’s health, inferring that somehow if you oppose this mandate, you are for making women less healthy. Since when did disease prevention and pregnancy prevention come to be regarded as the same thing?

I was a strong supporter of universal healthcare. It was one of the reasons that I voted for Obama in the last election. We even put a ‘Healthcare for All’ bumper sticker on our car. I still believe in that. Our insurance and healthcare system are broken and this failure has affected many whom I love dearly.

But instances where contraception is somehow medically necessary for women are extremely rare. In reality, oral contraception has been shown to raise a woman’s risk of stroke and breast cancer.  We are mandating ‘healthcare’ that makes women less healthy.  So let’s be honest, this mandate isn’t about preventing or healing illness in women, this is about ensuring that women can have satisfying sexual experiences while avoiding the natural results of those experiences.

I am all for women having dynamite sexual experiences, but I don’t see how this is such an inalienable right that the government must trample all other commitments to ensure that we do. And if this mandate is really about the government providing sexual freedom to women under the name ‘health care’, then where will it end? If we want to ensure that those adults who want to have sex can whenever they’d like, why not mandate free access to Viagra? Or, if we equate pregnancy prevention with disease prevention, why do we not also see the provision of children to those who desire them, necessary for the ‘health’ of women? Ought we mandate free access to fertility treatments and IVF, even though the latter most often involves some sort of abortive measure?

If we confuse prevention of disease and prevention of pregnancy, there is really no end to what we can mandate as long as we call it “healthcare.”

The other thing that I find absurd about this confusion is that it equates having a baby and having a disease.  I am unashamedly a feminist. I think that women’s bodies are amazing and ought to be celebrated, and I can think of little less pro-woman than equating a healthy woman’s body doing the miraculous work that it naturally does with ‘disease’.

I get that many people have no problem with contraception or abortifacients. I am not saying that all women should not use contraception. I’ve used it myself. I am saying, however, that if one chooses to use contraception, which is, by definition, non-essential for health, that one should pay for it. If one does not want to pay for it, there is absolutely free pregnancy prevention available to them: a) abstinence and b) Fertility Awareness Method, which every woman in America needs to learn if for no other reason than you will be far more in touch with your body than you would otherwise. Read about it here.

Among women, particularly educated women, the new trend is to battle to remove the historic stigma of pregnancy and women’s fertility. We are into showing our baby bumps proudly and having our babies naturally. There’s a push (which I’ve been part of) to allow women to breastfeed publically for as many years as we and our babies would like to and to provide women with employment alternatives that support breastfeeding and infant care.  We can’t have it both ways, ladies. We can’t ask the culture to applaud and respect our fertile, life-producing capabilities when we want children, and regard them as pathological and deleterious to our health when we do not.

[I posted an update in the comments].

4 responses

  1. Update: A friend emailed me a thoughtful and helpful response to this that I thought warranted an update here. She by in large agreed with what I’ve said here, but brought up that Endometriosis and Polycystic Ovarian Syndrome can be treated with oral contraception and that these diseases are not “extremely rare” as I said above. This is an important point. I didn’t know these were treated with oral contraception, and I’m grateful that my friend pointed this out. However, treatment of these illnesses are still a very small percentage of overall usage of contraception and presents quite a different scenario. In this scenario, a woman who has an illness takes a pill-in this situation, “the pill”-to treat this illness similar to how a woman with a bacterial infection would take an antibiotic. This is a different ethical situation than a healthy woman voluntarily taking a pill to prevent her body from responding naturally to sexual activity. It makes sense that if women have these unfortunate diagnoses,that they should have insurance coverage of ‘medicinal’ contraception if that is the best treatment. This is a vastly more limited instance than what HHS proposes. I am also wondering if this ‘solves’ the religious liberty issue. Could one of my Catholic friends (or protestant friends who knows a lot about Catholicism or former Catholic friends) tell me if there is provision in the Church’s teaching for contraception as a treatment for diseases? I am not Catholic and do not know.
    Secondly, she brought up the use of condoms, which obviously help prevent STD’s. Again, this is simply a percentage of what must be provided. Most contraception only provides pregnancy avoidance and not protection against disease. I do think it behooves unmarried sexually active women (and men) to wear condoms. However, if a woman makes a choice to have sex, it is her responsibility to choose to purchase condoms. Right now, they are pretty cheap (and remember that these are employed women who we are talking about in the HHS mandate.) Insurance is by and large meant to help with those situations that we do not choose like illness and injury (there are exceptions to this but in the main). It doesn’t make sense to me for one to choose sexual activity and then for it to be the Church’s responsibility to provide them with condoms. It is, as my friend David French (who is far to the right of me but still a great guy), says “compulsory participation in the sexual revolution.” And of course there is a free way to prevent STD’s that the Catholic Church fully endorses. Abstinence ought not be forced on adults but here it is not. Neither should providing for sexual activities that they find reprehensible be forced on Catholics.

  2. Great post, Tish. I really appreciate how you have crystallized the issue here, and applaud your courage in sharing your thoughts. If I may, I would just add an additional thought that I think figures heavily in the discussion. What emerges here it seems to me, and in the health care debate generally, is the darker side of American utilitarianism. That is, aside from the particulars of illness and disease and how they might burden the system overall, the idea that the mere existence of a human being “burdens” the system overall. That being the case (the argument goes), what better way to relieve that cost than to reduce births, and what better way to do that than to flood the marketplace with birth control despite any associated concerns of conscience?

    Like you, I think there are legitimate options for birth control. That said, I am alarmed at how easily this debate moves into the realm of eugenics, and how little we reflect on the implications of how a government dictated system can begin to determine the “worthiness,” “potential,” or “cost” of these lives. It ought to come as no surprise that (despite all the good intentions), the impact of our “greatest good for the greatest number of people” thinking and planning bodes ill for the poor and marginalized among us. We’ve been down this road before (as you can read here: with dire consequences. My hope is that more voices like yours will be heard, as these are weighty matters that transcend the challenges that come with running an efficient health care system.

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