If you think it isn't about sex, think again

What if there were something that simultaneously cut the unintended-pregnancy rate and the abortion rate, while saving a bundle of taxpayer money? Wouldn’t that be wonderful? Turns out there is. In 2009, the Susan Thompson Buffett Foundation donated over $23 million to the Colorado Family Planning Initiative, a five-year experimental program that offered low-income teenage girls and young women in the state long-acting reversible contraceptives (LARCs)—IUDs or hormonal implants—at no cost. These devices, which require no further action once inserted and remain effective for years, are by far the best method of birth control available, with less than a 1 percent failure rate. (The real-use failure rate for the Pill is 10 times higher.) One reason more women don’t use LARCs is cost: While they save the patient money over time, the up-front price can be as high as $1,200. (Even when insurance covers them, many teens fear the claim forms sent to their parents would reveal they are sexually active.) Another reason is that women simply don’t know about LARCs and assume the cheaper pills available at clinics are their only option.

Given the opportunity to make an informed decision at no cost, around 30,000 participants in Colorado chose LARCs. The results were staggering: a 40 percent decline in teen births, and a 34 percent decline in teen abortions. And for every dollar spent on the program, the state saved $5.85 in short-term Medicaid costs, in addition to other cost reductions and the enormous social benefit of freeing low-income teens from unwanted pregnancies and what too often follows: dropping out of school, unready motherhood, and poverty.

As Republican State Senator Kevin Lundberg put it, using an IUD could mean “stopping a small child from implanting.” (Fun fact: Lundberg is the head of the Senate’s Health and Human Services Committee.) That IUDs work by preventing the implantation of fertilized eggs is a cherished conviction of abortion opponents, who reject the massive amount of scientific evidence that the devices work by preventing fertilization. It is “theoretically possible” that IUDs can prevent implantation, Turok said, “but the chances are infinitesimally small.” And he noted that “every legitimate scientific organization defines pregnancy as implantation,” not fertilization. But to opponents, a woman with an IUD is like an abortion clinic on legs: Who knows how many “small children” she’s killing in there?

Besides, teenagers shouldn’t be having sex. “We’re providing this long-term birth control and telling girls, ‘You don’t have to worry. You’re covered,’” said Representative Kathleen Conti. “That does allow a lot of young ladies to go out there and look for love in all the wrong places.” (Because the fear of pregnancy has worked so well to keep girls virginal.) Other reasons to kill the program? IUDs cause breast cancer (unproved). Birth rates are down in two Colorado counties (so?). STD rates are up (no, they’re not; in fact, they’ve stayed the same, which strongly suggests LARCs don’t increase sexual activity).