could the emergency contraception decision make sense?

I feel obliged to comment on the jaw-dropping stupidity of the recent actions of the Obama administration regard access to emergency contraception.

I’ve been trying to work out what the administration gains from this betrayal of science and public health, because I simply cannot tolerate the idea that someone as intelligent and clear-thinking as Obama really BELIEVES that this is a “common sense” decision that makes sense to him as a father of two girls. That’s BULLSHIT. It’s got to be political.

So. I investigated some.

Rates of abortion among girls aged 15 and under is less than one per 10,000, compared with around 1 in 1,000 among girls aged 15-17 (these two groups combined represent about 6.4% of all abortions performed) and slightly over 2 per thousand among girls aged 18-19, according to the Guttmacher Institute. So the public health impact on reducing access to effective contraception is far less than, say, the impact of not allowing it for OTC sale to women over 17, which is what the Bush administration did until 2006, three YEARS after the FDA advised that it was safe.

This is not to minimize the importance of reducing barriers to access to girls under the age of 17. If you’re that girl whose condom broke or whose partner forced you to have sex without a condom or who can’t ask your parents about getting birth control, then being able to walk into a store, pick up a box, and buy it, is TOTALLY CRUCIAL. (Though, as Cora Breuner points out in the Time article linked above, how many of those girls have \$50 to buy EC?)

But say you’re a president. And say you want to make a public decision that will make you look good to people who don’t know much about these issues and are much better at being scared of young people’s sexuality than they are at being compassionate toward young people who have sex – because those ignorant, non-compassionate people are swing voters – but you want to do it without actually fucking up public health outcomes in a major way.

You’re not significantly increasing the pregnancy rate or the abortion rate, as measured at the population level, because those girls represent such a small proportion of the abortions performed in the U.S. And you’re not even meaningfully increasing the pregnancy rate, since access to EC is not correlated at the population level with reductions in the pregnancy rate. It’ll be easy to point to data that show that no harm was done.

And in 2012, when you’ve been elected for your second and final term, you can reverse the decision, with someone brilliant like Elizabeth Warren in the wings, knowing that the number of girls who suffered over the previous 11 months is a drop in the bucket compared to the number of women and girls who would suffer under any of the Republican contenders’ administrations.

(FYI: a handy summary of the age-and-EC research by RHTP (PDF).)

I’m not trying to be an apologist here – the decision is fraudulent and a vicious strike against both science and women’s reproductive health and rights. It’s BULLSHIT and it makes me angry. But I’ve respected a great deal of what the President has done, especially the measured, patient, and collaborative approach he has brought, even when the Republicans didn’t (in my view) deserve such respectful treatment. He’s Melanie Hamilton to my Rhett Butler: he’s all the things I can never be but that I respect as good and decent. So what in the world could induce Melanie Hamilton to support such a stupid decision?

Long-term harm reduction.

It’s an idea.

But don’t let this idea stop you from calling your representative, your Senators, and the white house, to explain to them that it’s BULLSHIT. BULL. SHIT.