The Washington Post

A complete guide to our complicated, unsexy relationship with birth control

A look at the numbers and stories behind America's relationship with birth control.

(Mike Derer/AP)

The Supreme Court recently ruled that some employers with religious objections don’t have to pay for birth control. Feminist blog Jezebel described it another way: “Earlier today, five men agreed that closely held corporations with anti-birth control religious beliefs cannot be required to provide contraceptive coverage to female employees. Corporations are people, my friend. Women? Not so much.”

Birth control, of course, is more than a pill or a political dispute. From the bedroom to the boardroom to the courtroom, it’s an integral (and thoroughly unsexy) part of American life.

1. An estimated 99 percent of sexually active women have tried at least one contraceptive method. Four of every five have used the pill, according to the CDC.

Today, there are 62 million U.S. women in their “childbearing years,” or ages 15 to 44, according to the Guttmacher Institute. Over the course of a year, couples who do not use contraception have an 85 percent chance of unintentionally conceiving. Birth control now plays a huge role in our lives, considering the average American lady must use it for three decades if she wants only two children.

Contrary to some lawmakers’ beliefs, birth control is used for more than pregnancy prevention. Hormonal methods — including the pill, patch and IUD — are prescribed to treat excessive menstrual bleeding, cramps and acne. More than half of pill users say they take it for health reasons, Guttmacher research shows. Fourteen-percent take it only for health reasons.

2. Sometimes lawmakers don’t understand lady-part maintenance.

Texas Monthly’s Mimi Swartz takes readers inside a debate and a, um, women’s health crash course among Texas lawmakers, who cut state funding for family planning and waged an “all-out war” against Planned Parenthood:

“‘What does this vaginal sonogram look like?’ Luna asked, ever curious.

‘Well, I’m glad you asked,’ Alvarado answered, ‘because instead of just describing it, I can show you.’

And so the state representative from Houston’s District 145 put both elbows on the lectern and held up in her clenched fist a long, narrow plastic probe with a tiny wheel at its tip. It looked like some futuristic instrument of torture. ‘This is the transvaginal probe,’ Alvarado explained, pointing it at her colleagues as she spoke, her finger on what looked like a trigger. ‘Colleagues, this is what we’re talking about. . . . This is government intrusion at its best. We’ve reached a” — she searched for the word — “climax in government intrusion.’”

3. And sometimes, abstinence can be the costliest birth control of all.

Tampa Bay Times reporter Weston Phippen describes a Florida family’s quest to break a three-generation “curse” — teen pregnancy — by fiercely guarding a 16-year-old girl:

“And yet curiosity in sex is not lost on Niya. At church she met a boy and the two exchanged numbers. Then they sent texts, and later Niki snooped through Niya’s phone and found indecent photos she’d sent to the boy.

‘What if you would have had sex?’ Niki asked her.

‘Maybe I do wanna have sex!’  Niya yelled back.

Even in God’s house the older women must be vigilant, because where there are broad shoulders and square chins, there looms a threat. After Niki found the photos, mother, grandmother, grandfather and her uncles lectured the girl on the intentions of boys, and reminded her once again what happens when you have sex. Then they took away Niya’s cellphone. In ways little and large, she was always paying for what happened half a century ago.”

Another spoiler alert: Abstinence-only sex education doesn’t always lead to abstinent behavior.

4. Hobby Lobby’s landmark argument cost less than $4 million.

In The American Prospect, reporter Amelia Thomson-DeVeaux brings us behind the scenes of a  little-known, non-profit law firm that became the leading advocate for a corporations’ religious rights:

“The fight over the Obama administration’s alleged infringement on religious freedom is Becket’s first extended turn in the national spotlight since it was founded in 1994. For more than two years, the fund — with a budget of less than $4 million and 11 lawyers on staff — has constructed the legal argument against requiring religious organizations to comply with the contraception mandate. Forcing any organization to subsidize health-care plans that defy its faith is, the fund claims, a breach of the Religious Freedom Restoration Act, a statute passed in 1993 that allows believers to demand exemptions from laws that place a “substantial burden” on their religious rights. Late in 2011, Becket filed the first suit against the mandate on behalf of Belmont Abbey College, a school founded by Benedictine monks. Since then — perhaps encouraged by its success in lower courts — the fund has agreed to represent six more nonprofits.”

5. A company’s religious beliefs can scare off customers.

In a personal essay for the Hairpin, writer Susan Schorn describes her complicated relationship with family traditions, affordable yarn and Hobby Lobby. Spoiler alert: She won’t be shopping there anymore.

“When you were raised to regard America as a refuge from ignorance and despotism — as many children and grandchildren of immigrants are — there’s something perverse about standing in the aisle at Hobby Lobby, contemplating all the varieties of yarn and what you might make of them, and realizing that, if you worked there, you’d have less control over your own healthcare, your own body, your own religious beliefs, and your own procreative decisions than you would over a stupid afghan.”

6. Writing about birth control before birth control could net you a hefty fine.

In the New Yorker, writer Elizabeth Kolbert introduces us to Dr. Charles Knowlton, who wrote about early birth control tactics in 1831 and was fined $50 in New York for publishing lewd content:

“In ‘Fruits of Philosophy,’ Knowlton took up the subject of sex, or population growth, which, at the time, amounted to much the same thing. Like Thomas Malthus, whose work he cited, Knowlton was worried about the hazards of fertility. Using nineteenth-century birth rates, he projected that the number of people on the planet would double three times every century. Unlike Malthus, who saw no remedy except plague or abstinence, Knowlton believed that a more agreeable solution was at hand. What he called the “reproductive instinct” need not actually lead to reproduction. All that was required was some ingenuity. ‘Heaven has not only given us the capacity of greater enjoyment, but the talent of devising means to prevent the evils that are liable to arise therefrom; and it becomes us, ‘with thanksgiving, to make the most of them,’  he wrote.

Dr. Knowlton might have been onto something. During the 19th century, the U.S. birth rate fell by half. Total female fertility dropped from seven children per woman in 1800, research shows, to less than four per woman at the end of the 19th century.

Danielle Paquette is a reporter covering the intersection of people and policy. She’s from Indianapolis and previously worked for the Tampa Bay Times. Follow her on Twitter: @Dpaqreport.



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