Blog #3: Fight for the things you care about
Hi, friends.
I had planned for my return from a nearly 3-month hiatus from this blog to talk about something fun that I enjoy (which is still coming - probably sometime later this week). But last night I got some news that sent me spiraling. Spiraling into sadness and uncertainty of our future.
Last night, it was reported that Ruth Bader Ginsburg, the second of four women appointed to the Supreme Court of the United States, had passed away due to complications from cancer at the age of 87. RBG, as she was so lovingly nicknamed, was a pioneer, a trailblazer. She graduated with her bachelor’s degree from Cornell University and studied law at Harvard and Columbia Universities, where she graduated at the top of her class. After receiving no job offers from any law firms in NY, Ginsburg became a professor at Columbia and Rutgers Law Schools. She was appointed to the Supreme Court in 1993. RBG was maybe best known for being a firm defendant of Women’s Rights and a warrior for Gender Equality.
As many mourned for RBG last night, I saw one common message that I’m acting on today. “Tonight, we mourn. Tomorrow, we fight.” Last night, I mourned. Today, I fight.
As a nation, we are facing so many issues as we approach the upcoming election. For many, the fight we need to fight is political. If no one has told you lately, we need to VOTE this election, not just in our own interests, but of the interests of those around us. We must carry on the fight that RBG fought for much of her professional career. But, with all due respect to Justice Ginsburg, I don’t love the idea of fighting a political fight. I don’t study politics and I don’t study law (too many words, not enough numbers lol). But I am a scientist. So what I can do, is fight this fight by talking about science and statistics, in a way that hopefully will shed light on the wonderful things she stood for (but also by voting, of course. I requested my mail-in ballot last week!). Without further ado, let’s talk science!
One of the causes Justice Ginsburg fought for was women’s access to contraceptives and proper reproductive healthcare. This is a major public health issue that is highly debated and easily influenced by many factors, including, most popularly, religious beliefs. However, studies have shown that proper access to contraceptives, something the current administration has fought to limit, leads to less unplanned pregnancies and better health outcomes for women of reproductive ages.
Most notably is a study out of Washington University in St. Louis School of Medicine by JF Peipert and colleagues, published in 2012 (source). This study aimed to reduce unintended pregnancies by providing no-cost contraception to women of reproductive ages. About half of unintended pregnancies, whether unwanted or mistimed, were caused by a total lack of contraception use, and the other half does to inconsistent/incorrect contraception use. The investigators planned to provide long-acting reversible contraceptive (LARC) methods, such as IUDs and contraceptive implants, at no cost to women who were considered to be at risk for unintended pregnancies in the St. Louis metropolitan area. They compared unintended pregnancy rates (measured by proxy as teen births, number of abortions, and repeat abortion rates) in the St. Louis metropolitan area to both regional and national rates. Almost 10,000 women between the ages of 14-45 were recruited to participate in the study. Since the distribution of this cohort of participants was skewed (median age = 25 years) and disproportionate to the general population of St. Louis (50% of participants were Black; while ~30% of St. Louis population is Black) the outcome measure rates were standardized to the age and racial distributions of the general St. Louis population. Of the 9,256 adolescents and women included in the study, 37% reported receiving public assistance, and 39% had trouble paying for basic expenses – already indicating the importance of free (or subsidized-cost) contraceptives.
At the start of the study, the participants chose their desired contraceptive of choice – over 75% of the cohort chose LARC (either IUD or implant) methods; the remaining 25% chose an oral contraceptive pill, patch, or other form of contraception. Over the course of this study, the teen birth rate in the study cohort (measured as births per 1,000 females between 15-19 years old) was 6.3 per 1,000. This is about 80% lower than the national US rate at the time, which was 34.1 per 1,000. When considering total number of abortions, during the 3 years of this study (2008-2010), the number of abortions performed at Reproductive Health Services in St. Louis City and County significantly decreased by 20% over 3 years - while the rates of abortions in all other counties in Missouri had no significant change over this time period. Even after adjusting for age and race, the abortion rate per 1,000 adolescents and women in the study were consistently at or lower than 50% those of the regional (i.e. other MO counties’) rate. Also, the percentage of abortions that were repeat abortions decreased in St. Louis during that same 3 year period, while the same measurement increased in Kansas City, MO, a city with comparable size and demographics to St. Louis.
These results all support the fact that accessible contraceptives, such as the ones provided to participants in the St. Louis area, can lower the incidence of unintended pregnancies and result in better, more healthy outcomes for adolescents and women. In my opinion, one of the keys to this study was the fact that these contraceptive methods were affordable, which can allow for women with less (or no) flexible income to still have access to contraceptives, preventing unplanned pregnancies and additional financial burdens. Now, of course this study has its limitations; one being the proxy measures of an intended pregnancy as teen birth rate, abortions, and repeat abortions. Also, this study uses a very specific sample within a single region of the country; perhaps other studies similar to this design can be repeated in other cities around the US (if they haven’t already been!). However, I think even with these limitations, there is a strong argument that cheap and accessible long-acting reversible contraceptives have beneficial effects on women of reproductive ages.
Access to women’s reproductive health and contraceptives is indeed a fight for gender equality. The fact that woman’s birth control options are even a DEBATE just goes to show how, even to this day, women and men are NOT treated equally, especially in regards to their own autonomy of their bodies (may I point out men’s contraceptives like condoms are available for purchase practically anywhere, no prescription or medical visit required). Maybe it’s about religion. Maybe it’s about power and control. But whatever it’s currently about, it’s not what it should be. It should be about facts. Science-based facts. And science-based facts have shown that access to and proper use of birth control lowers incidence of unintended pregnancies, as measured by both teen birth rates and by repeat abortion rates.
Okay fine, I’ll bring it back to politics. As recently as this past July of 2020, the Supreme Court ruled in a 7-2 ruling against making it easier to access affordable birth control, by allowing employers to take away birth control coverage from their employees (source, source). I will refer you to the three paragraphs above this one for why this does NOT help women. Science shows that accessible contraceptives lead to lower teen birth rates, lower abortion rates, and lower incidence of repeat abortions. This is something that hasn’t just been seen in the US, but worldwide (source). The fact that the highest Court in the land can rule against making contraceptives accessible to women shows that our government largely ignores science and is blatantly indifferent to the health and wellbeing of half of the population. Just absurd. No matter your religious or ethical beliefs, you must acknowledge that this is a disregard of a major public health issue.
This November we must to vote into office those who have the interest of Americans at heart. We must vote for those who listen to experts and scientists, whether it be in regards to women’s access to reproductive healthcare, or in the handling of this pandemic. We must elect those who trust the data, learn the facts, and implement policies that will benefit of ALL in this country. We simply cannot afford to vote any other way.
Justice Ruth Bader Ginsburg once said, “Fight for the things you care about, but do it in a way that will lead others to join you.” In honor of Justice Ginsburg, I’m fighting for science and for an equal, just and better America for all. I hope you’ll join.
Justice Ginsburg, I want to thank you for all that you have done for the millions of women in this country. You are one badass lady that I cannot wait to teach my daughters about one day. May your memory be a blessing.
And to those of you reading, thanks for taking the time. I’m sending you all my best.
Stay safe, stay smart, stay kind.
Talk to you next time,
-s
