We’re not sure when it became a tenet of the historically free-thinking, authority-questioning philosophy of atheism to reject the idea that couples can take care of their own damn fertility, but the writers at The Friendliest Atheist are brimming with confidence over the status quo, so we’ll leave them to it. In fact, we did leave them to it, when they ignored the medical value of NaproTECHNOLOGY because many of the doctors who practice it were — gasp — Catholics! (The peer-reviewed suggestion that endometriosis be exorcised of its demons unsettled them, apparently.)

But their latest critique of 1Flesh — claiming, no lie, that we get “fast and loose” with abortion facts — is so confidently ridiculous that someone has to break up the intellectual masturbation and make fun.

1Flesh cites a source claiming that 54% of abortions were performed on women who were using contraception when they got pregnant. The analysis:

The number appears to come from the Guttmacher Institute, in an article discussing abortion trends over 10 years ago (so already the very use of the present tense is questionable).

These statistics are the most recent available. Furthermore (and this is a part of our graphic happily ignored by the Friendlies) these statics have remained consistent whenever they’ve been measured. Women undergoing abortions were using contraception in the month they got pregnant at the following rates: 50% in 198858% in 1993 and 199458% in 199558% in 199658% in 1997, 58% in 1998, 54% in 2000, and 54% in 2001. Then the CDC stopped asking the question of whether women were using contraception during the month they became pregnant in their annual “Abortion Surveillance Reports”.

Our Atheistic Friends then quote the Guttmacher study:

“More than half of women obtaining abortions in 2000 (54%) had been using a contraceptive method during the month they became pregnant.”

Gee, anybody notice a difference? 1Flesh states that contraception was used when the women got pregnant, whereas the actual data merely states that contraception was used in the same general time period.

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OK, I’m going to assume this was an honest mistake on their part. Not everyone knows that the main medical method of determining the time of pregnancy is by something called LMP, last menstrual period, which is the reason Guttmacher ask women for “the month” and not the “moment of conception”.
But it doesn’t take a striking bloom of brilliance to figure this out. Women are not always fertile. The ovum sticks around for about 24 hours. Sperm survives in the female’s reproductive system for a while, giving an average fertile period of 3-5 days. Since most couples using hormonal contraception can’t know if they’re fertile, it’d be an impossible survey question to ask: “Were you using contraception at the moment of your conception.” Thus, and in the medical world, “when they got pregnant” is determined by the “month” (the whole menstrual cycle) and it is no dissimulation to use the terms we used.

(Unfortunately the graphic medium does not permit us to give these drawn-out explanations, so I do concede that we assumed some knowledge many may not have. But hey, now we’ve all learned something!)

…and incidentally, the actual statistics include withdrawal (pulling out before climax) and “periodic abstinence” (rhythm and its variants) in contraceptive methods.”

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Remind me, because life is complex, who the hell is talking about withdrawal and the rhythm method? 1Flesh advocates the use of fertility awareness, which has been shown to be as effective at family planning as the Pill. If you’re appealing to the statistics garnered by other methods, you’re flailing at ghosts. While this makes sneering easier, it obscures the truth at hand, and only allows for those deep feelings of self-justification in an sympathetic atmosphere which kindly overlooks the absence of your target.

“Another 38% of abortions were performed on women who used contraception, just not during the month they got pregnant, because sex was unexpected, they thought they could risk it, etc.”

That’s nice. I hear a lot of deadly car crashes happen with drivers that previously used seat belts, just not that day, because it was just a quick drive, no one is on the road, they thought they could risk it, etc. I guess that shows seat belts don’t work, eh?

Oh, you rogues. While this does represent the precise conclusion a 5-year old could draw from the argument, the reality goes a little deeper. The question is not whether contraception worked when a couple didn’t use contraception. If this was our argument, we should certainly be crucified for it. The question is whether a contraceptive mentality leads to a culture that is more tolerant of the injustice of abortion.

Those not “currently” using contraception are obviously not evidence of contraception’s failure to prevent unintended pregnancy. They do, however, represent the truth that Stanley K. Henshaw of the Guttmacher Institute pointed out: “contraceptive users appear to have been more motivated to prevent births than were nonusers.”

That the vast majority of abortions are performed on women who were either using contraception during their last menstrual period (54%), or did use contraception but for whatever reason not during their last menstrual period (38%), seems to indicate that a mentality of contraception does indeed lead to a mentality of abortion.

From here on the silliness comes on, er, “fast and loose”. I believe that’s the empowering term we’re rolling with.

“The probability of unintended pregnancy in 1 year of contraceptive use is 12%”

This information comes from a CDC report (PDF). 1Flesh loves citing the CDC, and they dearly hope you never, ever listen to what the CDC says about contraception.

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Again with the slavery to dogma. It is not OK to deny the scientific findings of an organization, if those findings are the result of good methodology. It is certainly OK to disagree with the conclusions and organization draws from the same findings. The Friendzoned Atheists link the CDC’s evaluation of the various use effectiveness ratings. We agree with the ratings. We disagree with the implication that, as a result of these ratings, a whole crap load contraception will save the world from unintended pregnancy. It’s called critical thinking, friends. It’s OK to question authority, which may always be submitted to the truth, and we hope you’ll forgive us for taking this as self-evident.

Like the previous figures, this figure for failure rates includes abstinence and withdrawal, and also adds spermicides, which when used alone are even worse than pulling out.

Again with the flails. What withdrawal, spermicidal, abstinence crew are you waging war against? Point them in our direction, as I imagine we’re far more eager to rebut their claims than even the friendliest of atheists.

Having stumbled to the finish line, the indictment comes out, the high ground is taken, and the conclusions of 1Flesh are demolished in a mortar barrage.

The CDC cites 12% as the average failure rate for “typical use.” This refers to how the method works in the population, to contrast it with “perfect use.” “Perfect use” failure rates are much lower than those of “typical use” because they happen in the context of clinical studies, where couples are educated on their use and cautioned to use them consistently and correctly. Comprehensive sex education aims, among other things, to bring the “typical use” rates closer and closer to the “perfect use” rates, by encouraging correct and consistent use of contraceptives. 1Flesh draws a different conclusion:

“those opposing abortion should not promote a culture of contraception”

Because if people stop using contraception, they’ll also stop having sex and unplanned pregnancy rates will go down. Obviously.

I suppose it’s fitting that misinterpreted and misrepresented evidence be used to support a faulty premise with a delusional solution.

Bullshit. Here’s the real issue. When confronted with the fact that the majority of abortions are performed on contraceptive-using women, the immediate answer our culture has given is a cry for greater education so we can become really good at using contraception. It’s a little like Communism in this regard: It’s not that it hasn’t worked, it’s that it has never been properly implemented.

This is not a bad thesis: Greater theoretical knowledge will fix the problems of typical use.

But.

We’ve seen a massive increase in the amount of comprehensive sex education in the United States. It first became a reality in the 80’s, and has increased in proliferation to the point that now, according to the Guttmacher Institute (and yes, this is one of those use-the-statistic-reject-the-conclusion things), only “about one-third of teens had not received any formal instruction about contraception”. Despite this, and as shown by previous CDC statistics, the rate of women undergoing abortions who were using contraception during the month of their pregnancy has remained a consistent majority. Increased contraception education was unable to reduce the number of abortions performed on women using contraception as it proliferated from a minutia of teens to two-thirds of teenagers. The idea that it will certainly make a comeback if it moves from 66% to 100% is enthusiastic at best.

This was the point of mentioning a fact the Friendlies deemed unmentionable in their analysis: In 1 year, 12% of those using contraception will remain pregnant, and this statistic has remained unchanged since 1995. Comprehensive sex education has increased. Contraceptive use has increased. And our embarrassingly high unintended pregnancy rate remains.

The leading OB/GYNs of the United States don’t seem so enthusiastic in regard to an approach of “more education!” They’ve gone from promoting “light” contraception for teenagers — like condoms and birth control pills — to promoting long-acting, semi-permanent contraception, like IUDs, injections and implants. Laud the move as wise if you will, but it doesn’t represent the hope that “if people were better at using contraception, everything would be OK.” No, it says that people suck at using contraception, let’s promote contraception taken once and forgotten about. It is a change of method, not an increase in education.

Allow us to suggest just three reasons why humans suck at using contraception, and why increased contraceptive education — while it may or may not (statistically) harm the abortion rate — ultimately won’t help. They all amount to the following thesis: The reality of sex and natural psychology of the human person works against his or her efforts to effectively use contraception. Read them if you will.

Risk Compensation

The study “Risk compensation: the Achilles’ heel of innovations in HIV prevention?” states:

“Risk compensation has complicated the introduction of other preventive innovations. Although studies show that seatbelts help protect people in a collision, the evidence is less compelling that the diffusion of seatbelts as a public health measure has contributed to overall reductions in deaths from motor vehicle crashes in some settings. This may be because people presume that wearing a seatbelt will protect them from their risky driving. Similarly, studies have found an association between use of sunscreen and increased risk of melanoma, related to compensatory increases in exposure to the sun. These and other examples have led researchers to suggest that risk compensation may help explain the limited effect of promoting condoms on HIV rates in highly generalised epidemics…”

While the study refers primarily to the HIV crisis, the current unplanned pregnancy crisis in the United States is similarly a generalized problem, with 49% of pregnancies arriving unplanned. As with the HIV crisis, the effect of promoting contraception as a general solution to this general problem has certainly had “limited results”. It’s unchanged from 1994. The study on Risk Compensation goes on to state that:

Consistent use of condoms has been shown to reduce the efficiency of transmission of HIV and various other sexually transmitted infections, but the perception that using condoms can reduce the risk of HIV infection may have contributed to increases in inconsistent use, which has minimal protective effect, as well as to a possible neglect of the risks of having multiple sexual partners. Thus, the protective effect of promoting condoms may be attenuated at the population level and could even be offset by aggregate increases in risky sexual behaviour.

If a protective technology is given, humans naturally involve themselves in riskier behavior. This is a psychological reality, not overcome by being really, really clear about the 12 steps of safe condom use.

The Effect of Sexual Arousal on Decision Making

Sexual arousal is associated with poor decision-making in men. The study “The Heat of the Moment: The Effect of Sexual Arousal on Sexual Decision Making”, published in the Journal of Behavioral Decision Making found that “sexual arousal had a strong impact on[…]judgment and decision making, demonstrating the importance of situational forces on preferences, as well as subjects’ inability to predict these influences on their own behavior.” Subjects were asked to answer questions regarding condom use while sexually aroused, and it was found that:

For all four condom-related questions, subjects in the aroused treatment indicated a lower likelihood of using a condom compared with subjects in the non-aroused treatment…when it comes to concrete steps involving condoms, sexual arousal changes one’s perceptions of the tradeoffs between benefits and disadvantages in a fashion that decreases the tendency to use them.

Sexual arousal, the only state in which it is “necessary” for men to wear condoms, makes men less likely to wear condoms and more likely to engage in risky sexual behavior. This chemical change in decision-making skills may be in part why in a study of 158 college students entitled “Condom Use Errors and Problems Among College Men”, it was found that:

“60% did not discuss condom use with their partner before sex; 42% reported they wanted to use condoms but did not have any available; 43% put condoms on after starting sex; 15% removed condoms before ending sex; 40% did not leave space at the tip; 30% placed the condom upside down on the penis and had to flip it over; and 32% reported losing erections in association with condom use. Nearly one-third reported breakage or slippage during sex.”

Despite increased education, condom use error is heavily prevalent. A review of all available literature entitled “Condom use errors and problems: a global view” is worth checking out. It records amongst diverse populations the frequency of late application, early removal, incomplete use, completely unrolling the condom before putting it on, not leaving space at the tip of the condom, not squeezing air from the tip before use, putting the condom on inside out and then flipping it over to use, starting sex before the condom was unrolled to the base of the penis, damage issues (using a sharp object to open the package, letting the condom contact a sharp object, knowingly using a damaged condom, not checking for physical damage), lubrication issues (condom not lubricated, using oil-based lubricant), incorrect withdrawal, not holding base of condom during withdrawal, reuse of a condom (during same sexual encounter), storage and expiration date issues, fit issues, feel issues, and condom-associated erection problems.
The fact that the act of sex makes consistent, effective behavior difficult is not solved by merely teaching consistent, effective behavior. What’s needed is self-control, and that’s something that a comprehensive sex education class, or any public school class, cannot teach.

Habit Persistence

Another factor at work here is the principle of habit persistence. Condoms allow young people to get into the habit of sex who otherwise would remain abstinent — a habit difficult to stop. The study “Habit Persistence and Teen Sex: Could Increased Access to Contraception have Unintended Consequences for Teen Pregnancies?” predicted that:

Should contraception become more available, those who switch from unprotected sex to protected sex will lower the teen pregnancy rate, while those who move from abstaining to protected sex will increase the teen pregnancy rate due to contraception failure.

They go on to show that it is extremely unlikely, once the first-time sex barrier has been breached, that a teenager will not have sex again in the near future. The habit of sex is a persistent one. Since contraception does not eliminate the risk of unplanned pregnancy, but merely reduces it, then the distribution of contraception, in that it allows otherwise abstinent teenagers to breach the first-time sex barrier and thus form a continual habit, may eventually result in an increase, not a decrease, in unplanned pregnancies. At the least, as the author’s suggest, this break of the “first-time” barrier will have the effect of canceling out the gains otherwise made by contraception. Current unplanned pregnancy rates seem to agree.
Obviously, habit persistence is not an issue solved by increased education.

We’re advocating a personal decision. Ditch the contraceptive mentality that says that women cannot know their own fertility and must rely on imperfect help of pharmaceuticals to family plan, that men cannot control themselves in regards to sex, and that children are an unintended consequence to be avoided via the use of technology each and every time the act of sex is performed. In a world in which the proposed choices are limited to the universalization and perfection of contraception and the fear-based pretense that sex is bad and a thing to be resisted, we respectfully return our ticket. Fertility awareness is self-knowledge every woman can have to effectively family plan and to treat any health issues. It directly combats the contraceptive mentality, and seems a far better way than the current pit our sexual culture offers us.