Earlier this week, the Supreme Court ruled in favor of Hobby Lobby, striking a blow against women’s ability to access effective forms of contraception. The majority opinion concluded that “closely held” for-profit corporations with religious objections to certain types of contraception do not have to cover all FDA-approved contraceptives in their employee insurance plans.
This ruling does not deny coverage for all forms of contraception, but only for forms that may prevent implantation after an egg has been fertilized. This includes emergency “morning after” contraception (such as Plan B), but it also includes intrauterine devices (IUDs). IUDs typically intervene in a pregnancy by preventing fertilization, but can also be used as emergency contraception if inserted up to five days after unprotected sex.
The argument put forth by Hobby Lobby (and accepted by the Supreme Court) is that emergency contraception and IUDs are “abortifacients,” meaning they abort fertilized embryos. However, there is no medical consensus that this is true. Multiple scientific studies have found that IUDs and emergency contraception do not work by preventing implantation but instead work through preventing fertilization. Other studies find that while these methods work primarily through preventing fertilization, they cannot rule out that IUDs and morning after methods affect implantation. However, the American Congress of Obstetricians and Gynecologists defines conception as the moment when a fertilized egg implants in the uterus, meaning that even if IUDs and “morning after” pills work by preventing implantation, they intervene before conception begins.
Any restrictions on women’s access to contraception are troubling, but this ruling is particularly worrisome because it targets IUDs, which are one of the most effective forms of contraception. IUDs have much lower failure rates than other forms of contraception, such as the condom or the Pill. IUDs are particularly effective because they are user-friendly, changing the default from having to manage your fertility on a regular basis by taking a pill or remembering a condom to not getting pregnant until you take deliberate steps to do so. The CHOICE project, a study of over 7,000 women in the St. Louis region, found that the risk of pregnancy for a contraceptive-using woman was twenty times higher if that contraceptive was the Pill, transdermal ring, or hormonal patch rather than an IUD. Use of these more effective forms of contraception also reduced the abortion rate by 75% – something pro-life activists should appreciate.
A growing number of women in the United States are having children outside of marriage and before they are ready or want to be a parent. About 60 percent of births to single women under 30 are unintended. An unintended birth is one which the mother characterizes as mistimed or wholly unwanted.
Access to effective and easy to use contraception allows women to better control their fertility and in turn, improve their education, employment, and wages. Our research shows that reducing unintended pregnancies would improve the lives of not only the young women who are delaying childbearing until they are ready, but also the lives of their future children. Making more forms of contraception, particularly expensive methods such as IUDs, more accessible is an important step to improving the lives of disadvantaged women and their children. If yesterday’s ruling is emblematic of a broader attempt to curtail women’s ability to control their own destinies, it is disturbing and potentially damaging to both women and to the next generation’s prospects of success.