HEALTH CARE/Joan Retsinas

Bedroom Certitudes

Oh for the certitude of an ideologue, one who glimpses Truth, and wants to impose that Truth on a world of heretics.

The world is replete with ideologues. Think of Afghanistan, where fundamentalists force women to don shroud-like chadors and men to grow beards. The United States is too pluralist a nation to let ideological fervor threaten individual freedoms. Or so we believe.

The Bedroom Ideologues are challenging that happy belief.

The Bedroom Ideologues have long warred against abortion. Equating abortion with murder, the ideologues have erected roadblocks. Thanks to the Supreme Court (Roe v. Wade), women can legally get abortions, but they can’t get them easily. We have waiting periods, bans on second-trimester procedures, requirements for parental notification, restrictions on insurance payment. In a pluralist nation deeply divided on the morality of abortion, such accommodation reflects the deep schism.

The Bedroom Ideologues, though, have turned their fervor to a new evil: contraception. From one vantage, giving women access to contraception will lower the number of abortions. “Responsible sex” is the mantra – meaning that people take responsibility for avoiding pregnancy.

From the ideologues’ vantage, contraception is a variation of abortion. During intercourse, that egg and random sperm, left to their own devices, might well unite, to create a baby. But the hormones in IUDs, pills, and patches block the mating. How horrific!

Even though millions of American women don’t think that it is horrific to block the mating—indeed, think it the moral, responsible action — the ideologues differ. And they are pushing their perspective forcefully.

Already states have “freedom of conscience” laws, letting nurses, pharmacists, and physicians say “no” to women seeking contraceptives. In some states those conscience-bound health-care providers must direct women to alternative providers who will say “yes;” but in small communities with few alternatives, the woman seeking “yes” may have to travel.

Insurers, too, can say “no” to contraceptives. A health plan doesn’t need to reimburse them, even though a physician has prescribed them. Twenty-seven states mandate that insurers cover contraceptives, but most of these states allow exclusions. (And state mandates don’t cover self-insured plans.)

These restrictions have made it more expensive, and more difficult, for some women to use contraceptives. But many Americans have accepted these restrictions as part of the rapprochement with a vocal, fervent ideological bloc.

The latest ideological incursion into the bedroom, though, is frightening both in its chutzpah and in its consequences.

This administration has given its blessing to a concerted attack on contraceptives. Bedroom Ideologues want to define “contraception” as an “abortifacient.” Defined thus, contraceptives will fall more easily under the restrictive rules that govern abortion. This definition will make it far easier for physicians, clinics, and hospitals to say “no” to women who seek contraceptives. Indeed, it will make it easier for those providers to refuse even to discuss the option.

Crucially, ideologues want to go one step further: They want to expand the health service personnel who can refuse to participate in the administering of abortifacients to include not just doctors and nurses, but janitors, clerical staff, administrators—employees tangentially involved.

The consequences evoke a brave new world of idiocy. Imagine family planning clinics that don’t dispense contraceptives. Those clinics can’t help patients plan their families. (Those clinics can advocate abstinence and the method of timing passion against hormonal secretions; but realists concede the limitations of those methods.)

More than a century ago, ideologues held sway over Americans’ sexual mores. States banned the use of contraceptives. In 1965 the Supreme Court struck down Connecticut’s 1879 ban (Griswold v Connecticut), postulating a right of privacy. In 1972 the Supreme Court extended that right to unmarried couples (Eisenstadt v. Baird). The judicial message was clear: lawmakers should stay out of bedrooms.

This current back-to-the-future incursion into the bedroom, whatever the proponents believe, will not change women’s mind-sets: women are unlikely to see the same light that the ideologues see, to embrace abstinence, or joyfully accept every mating of egg and sperm.

The Bedroom Ideologues loathe abortion; yet, ironically, in lobbying to limit contraceptives, the Bedroom Ideologues might well increase the number of abortions.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, Sept. 15, 2008

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