The debate over contraception and abortion has raged around moral issues such as whether or not destruction of a conceptus (a fertilized ovum) is equivalent to destruction of a human life, and whether or not the use of contraception promotes promiscuity in women. I have yet to see the issue of promiscuity in men addressed except as it relates to rape; I have never seen it referenced in any contraception discussion I have read, heard, or watched.

Several issues of major human concern, which I have never seen addressed by those who are anti-choice or against birth control, and which are seldom considered even by pro-choice advocates, include:

  1. women’s physical well-being,
  2. human social well-being, and
  3. environmental well-being (quality of life on this planet).

In the next three blogs, I will address these three issues, which are effectively at the ethical core of the debate over contraception and abortion. These are larger issues about long-term human survival, unlike the false debate about whether a cell (or a cluster of cells) with 46 chromosomes is a human being.

First of all, it’s important to acknowledge up front that the reproductive system, unlike all other bodily systems, is NOT designed for the preservation of the individual. All other systems of the body—for example, gastrointestinal, endocrine, and urinary systems—contribute to the maintenance and well-being of the person in whom they are found.

The function of the reproductive system, by contrast, is procreation and preservation of the species. It does not contribute to homeostasis; indeed, it frequently throws off the metabolic balance of the individual. A pregnant woman may develop gestational diabetes, for example—or osteoporosis, or circulatory problems, or pelvic floor damage, or lower back problems. So whatever else a pregnancy does, it takes a serious toll on the body of the woman carrying it, which can lead to long-term health problems.

Indeed, under circumstances “in the wild,” where no medical care is available, the likelihood of a woman dying in child-birth over her lifetime is about one for every seven to ten women. This dismal maternal death rate persists in many parts of Africa.

Comparable maternal mortality was also the case in the U.S. in the 1700s and early 1800s. Oddly, in the late 1800s, childbirth death rates actually increased substantially, largely because physicians replaced midwives as childbirth assistants. “Doctors” were often ill trained, were inclined to use instruments, and did not use aseptic technique. So the incidence of puerperal (childbirth) fever rose alarmingly, in some places as high of 40% of all deliveries.

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Figure: Annual death rate per 1000 total births from maternal mortality in England and Wales (1850-1970)

J R Soc Med. Nov 2006; 99(11): 559–563.

These figures fit well with information from my own family history. My great-grandfather, an immigrant from Cornwall to the Upper Peninsula of Michigan in the late nineteenth century, had a total of twenty one children, with three (sequential) wives, two of whom died in childbirth. And only seven of the children survived to adulthood, one of which was my grandfather.

So it certainly was dangerous to be a woman prior to the mid-twentieth century. And the past high mortality among women may account for much of our culture’s patriarchy; it has always been debilitating and/or limiting to carry, bear, and care for children.

Along with improved medical care, the availability of birth control has enhanced the health and productivity of women in this and all other modern nations. Those who wish to limit women’s access to birth control apparently do not care about women’s health. To try to turn back the clock on the past century’s improvement in the well-being of women is cruel, unthinking, and barbaric.

The next in this series in on contraception and social well-being.