Health care law fuels contraception controversy on Catholic campuses

Published 4:00 am Saturday, February 4, 2012

Bridgette Dunlap, a Fordham University law student, knew the school’s health plan had to pay for birth control pills, in keeping with New York state law. What she did not find out until she was in an examining room, “in the paper dress,” was that the student health service — in keeping with Roman Catholic tenets — would simply refuse to prescribe them.

As a result, students have had to go to Planned Parenthood or private doctors to get prescriptions. Some, unable to afford the doctor visits, gave up birth control pills entirely. In November, Dunlap, 31, who was raised a Catholic and educated at parochial schools, organized a one-day, off-campus clinic staffed by volunteer doctors who wrote prescriptions for dozens of women.

Many Catholic colleges decline to prescribe or cover birth control, citing religious reasons. Now they are under pressure to change. This month the Obama administration, citing the medical case for birth control, made a politically charged decision that the new health care law requires insurance plans at Catholic institutions to cover birth control without copayments for employees, and that may be extended to students. But Catholic organizations are resisting the rule, saying it would force them to violate their beliefs and finance behavior that betrays Catholic teachings.

“We can’t just lie down and die and let religious freedom go,” said Sister Mary Ann Walsh, a spokeswoman for the U.S. Conference of Catholic Bishops.

The administration’s rule has now run headlong into a dispute over values as Republican contenders compete for the most conservative voters. In an election season that features Newt Gingrich and Rick Santorum, who have stressed their Catholic faith, scientific thinking on the medical benefits of birth control has clashed with deeply held religious and cultural beliefs.

The Obama administration relied on the recommendations of the Institute of Medicine, an independent group of doctors and researchers that concluded birth control is not just a convenience, but is medically necessary “to ensure women’s health and well being.”

About half of pregnancies in the United States are unplanned, and about four out of 10 of those end in abortion, according to the Institute of Medicine report, which was released last July. It noted that providing birth control could lower both pregnancy and abortion rates. It also cited studies showing that women with unintended pregnancies are more likely to be depressed and to smoke, drink and delay or skip prenatal care, potentially harming fetuses and putting babies at increased risk of being born prematurely and having low birth weight.

But the Republican presidential contenders have said moral and religious values weigh heavily in birth control issues. Andrea Saul, a spokeswoman for Mitt Romney, said in an email that he regarded the administration’s rule requiring religious employers to furnish birth control as wrong. “This is a direct attack on religious liberty and will not stand in a Romney presidency,” she said. Romney has also pledged to end a federal program, Title X, that provides family planning services to millions of women.

Santorum has taken the position that health insurance plans should not be required to cover birth control. He also favors allowing states to decide whether to ban birth control. He and Gingrich both support “personhood” initiatives that would legally declare fertilized eggs to be persons, effectively banning not just all abortions but also certain contraceptives, including IUDs and some types of birth control pills.

Gingrich wants to withdraw government money from Planned Parenthood because it performs abortions in addition to providing contraceptives, though the federal money cannot be used for abortion.

Some Catholic colleges are likely to ask for a yearlong delay in implementing the rule on birth-control coverage, said Michael Galligan-Stierle, president of the Association of Catholic Colleges and Universities. In the longer run, he predicted in a statement that either Congress or the Supreme Court would invalidate the rule. Belmont Abbey College, which is Catholic, and the interdemoninational Colorado Christian University have already sued the Department of Health and Human Services, arguing that the birth-control requirement violates the right to freedom of religion.

Birth control is considered a “preventive service” under the new health care law, but Galligan-Stierle said such services should be limited to preventing disease, not pregnancy.

“We do not happen to think pregnancy is disease,” he said. “We think it’s a gift of love of two people and our creator.”

Despite Catholic teachings, surveys have found that 98 percent of sexually active Catholic women, as in the general population, have used contraceptives.

At some schools, students say the rules are so stringent that they have a hard time getting coverage even if they need birth control pills for strictly medical reasons.

Senior Catholic officials said that students at Catholic universities should know what to expect, and that those who disagree with the policies can go elsewhere. “No one would go to a Jewish barbecue and expect pork chops to be served,” Galligan-Stierle said.

Excerpts from a report on women’s health

When the Obama administration wanted a list of preventive services that women needed to stay healthy and that should be insured with no copay, it commissioned a report by the Institute of Medicine, an independent group of doctors and researchers. Increased access to contraception made the list. The institute’s report found the following:

• In 2008, about half of all pregnancies in the United States were unplanned, and 42 percent of the unintended pregnancies ended in abortion. When the use of birth control went up, rates of unintended pregnancy and abortion fell. Copays prevented some women from using contraception.

• Women with unintended pregnancies were more likely to be depressed and to do things that could harm the fetus, such as smoking, drinking and delaying or skipping prenatal care. As a result, babies from unintended pregnancies were at increased risk of prematurity and low birth weight and were less likely to be breast-fed. Similar risks occurred when births were too closely spaced. Birth control was important to keep pregnancies at least 18 months apart.

• Birth control pills are also used to treat menstrual problems, some migraine headaches, acne, pelvic pain, excessive hair growth and other conditions. They can also reduce the risk of endometrial cancer, pelvic inflammatory disease and some benign breast diseases.

• Risks and side effects from contraceptives are “minimal.” Death rates from pregnancy are higher than those from birth control, except among smokers who take birth control pills.

— New York Times News Service