Tuesday, May 02, 2006

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By Nicholas D. Kristof from The New York Times

Abortion may be the single most polarizing issue in America today, but there's one thing Democrats and Republicans mostly agree on: it would be better if Americans had fewer abortions.

The best way to reduce the number of abortions, in turn, would be to reduce the number of unwanted pregnancies. Every year, Americans have three million unplanned pregnancies, leading to 1.3 million abortions.

So it should be a no-brainer that we increase access to contraception, and in particular make the "morning after" pill available over the counter. That would be the single simplest step to reduce the U.S. abortion rate, while also helping hundreds of thousands of women avert unwanted pregnancies.

Plan B, the emergency contraceptive, normally prevents pregnancy when taken within 72 hours of unprotected sex — although it is most effective when taken within 24 hours. It is now available in most of the U.S. only by prescription, but the American Medical Association and the American College of Obstetricians and Gynecologists have both endorsed it for over-the-counter use.

President Bush's Food and Drug Administration has blocked that, apparently fearing that better contraception will encourage promiscuity. But unless the libidophobes in the administration mandate chastity belts, their opposition to Plan B amounts to a pro-abortion policy.

One study, now a bit dated, found that if emergency contraceptives were widely available in the U.S., there would be 800,000 fewer abortions each year. And even though they are generally available only by prescription, emergency contraceptives averted 51,000 abortions in 2000, according to the Guttmacher Institute.

That's one of the paradoxes in the abortion debate: The White House frequently backs precisely the policies that cause America to have one of the highest abortion rates in the West. Compared with other countries, the U.S. lags in sex education and in availability of contraception — financing for contraception under the Title X program has declined 59 percent in constant dollars since 1980 — so we have higher unintended pregnancy rates and abortion rates.

Germany, the Netherlands and Belgium have abortion rates only one-third of America's, and France's is half of America's. France has made a particular push for emergency contraception to lower its abortion rate by making free morning-after pills available to French teenagers, without informing the parents. Nurses in French junior high and high schools are authorized to hand out emergency contraception pills.

That broad availability is the global pattern. While American women cannot normally obtain emergency contraception without a prescription (by which time the optimal 24-hour window has often passed), it is available without a prescription in much of the rest of the world, from Albania to Tunisia, from Belgium to Britain.

One thought that paralyzes the Bush administration is that American teenage girls might get easy access to emergency contraception and turn into shameless hussies. But contraception generally doesn't cause sex, any more than umbrellas cause rain.

The reality is that almost two-thirds of American girls have lost their virginity by the time they turn 18 — and one-quarter use no contraception their first time. Some 800,000 American teenagers become pregnant each year, 80 percent of the time unintentionally.

So we may wince at the thought of a 15-year-old girl obtaining Plan B after unprotected sex. But why does the White House prefer to imagine her pregnant?

Indeed, Plan B may be more important for teenagers than for adults, because adults are more likely to rely on a regular contraceptive. Teenagers wing it.

Granted, making contraceptives available — all kinds, not just Plan B — presents a mixed message. We encourage young people to abstain from sex, and then provide condoms in case they don't listen. But that's because we understand human nature: We also tell drivers not to speed, but provide air bags in case they do.

The administration's philosophy seems to be that the best way to discourage risky behavior is to take away the safety net. Hmmm. I suppose that if we replaced air bags with sharpened spikes on dashboards, people might drive more carefully — but it still doesn't seem like a great idea.

So let's give American women the same rights that they would have if they were Albanians or Tunisians, and make Plan B available over the counter. It's time for President Bush to end his policies that encourage abortions.

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