American Forum Op-Ed

COLORADO EDITORIAL FORUM
By Emilie C. Ailts

Access to abortion is being used to hijack legitimate debate about the scope and type of health care reform.

While it’s true that abortion is a complex issue that brings out strong emotions from all ends of the spectrum, it’s important to remember that abortion is just one aspect of the full range of reproductive health care services a woman may seek throughout her lifetime. This headline-grabbing focus on the “a-word” means opportunities to use health care reform to increase access to and use of other vital reproductive services could be lost to political gamesmanship.

Take, for example, gaps for those women who choose to carry their pregnancies to term. In 2007, the National Women's Law Center ranked Colorado 42nd overall when it came to women receiving adequate prenatal care. Research has tied inadequate prenatal care to premature and low-weight births -- which in turn can lead to children exhibiting behavioral and developmental problems.

How can health care reform address this gap? We know that some insurance companies consider pregnancy a pre-existing condition -- grounds to deny coverage. In addition, rates for some insurance plans are based on gender; as a result, women get charged more for the same coverage as men their age even though pregnancy usually isn’t covered in these plans. Because of these practices, women face financial hurdles in obtaining the prenatal care they need to have a healthy pregnancy and to deliver a healthy baby. There’s clearly room for improvement in just those aspects of the health care system.

We also know that inadequate prenatal care can be a consequence of unintended pregnancy. In an ideal world, women would get pregnant only when they're ready to become parents. However, four out of every 10 babies born in Colorado are the result of unintended pregnancies. Why does this matter? Simply put, unintended pregnancies have serious consequences for women, their families, and their communities.

Research has shown that children of unintended pregnancies are at greater risk of being abused or neglected. We also know that women facing unintended pregnancies risk not completing high school and/or forgoing higher education. As a result, they have fewer employment opportunities and are more susceptible to perpetuating cycles of poverty where they find themselves dependent on taxpayer-funded welfare programs.

In today’s economic climate, unintended pregnancy has distinct financial ramifications for publicly funded programs like Medicaid, which paid for nearly 40 percent of all births in Colorado in 2003 to the tune of $261 million. The state is facing a $320 million shortfall in the 2009-10 budget. Imagine which programs and services -- whether public universities, DMV offices, mental health facilities, or prisons -- could avoid cuts if taxpayers weren’t paying for costs related to unintended pregnancies.

Over the last three years, the NARAL Pro-Choice Colorado Foundation has carried out research to understand barriers to preventing unintended pregnancy. Working through the Prevention First Colorado Coalition, we explored barriers and challenges women face in using contraceptives consistently and correctly when they do not want to become pregnant.

The research produced a number of findings, including identifying populations of women most at-risk to experience unintended pregnancy. Women living in rural or small-town communities, for example, compared to urban counties, had higher rates of births to girls aged 15 to 17, unintended pregnancy, and inadequate prenatal care.

Our research also revealed that regardless of the type of insurance a woman has, roughly half of women reported using contraceptive methods that are less effective as pregnancy prevention -- such as spermicidal foam or jelly, sponges, or condoms. Moreover, less than half of all women reported that they currently use a contraceptive method typically covered by insurance.

Those and other findings reveal a need to look for opportunities for systemic changes to prevent unintended pregnancy when reforming our health care system. At the top of the priority list should be a declaration that unintended pregnancy is a public health priority that affects all Colorado families and communities. By doing so, Colorado can make coordinated, strategic strides toward reducing not only unintended pregnancy, but also the need for abortion, infant mortality rates, disparities in health care access, and taxpayer coverage of avoidable health care expenditures.

It’s time to stop letting divisive rhetoric around abortion preclude necessary conversations about the need for sound policies to reduce unintended pregnancy, promote education, and improve access to birth control and prenatal care.
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Ailts is executive director of Denver-based NARAL Pro-Choice Colorado.
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Copyright (C) 2009 by the Colorado Editorial Forum. 9/09