Finding common ground between pro-life and pro-choice movements
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As I ended my day a couple weeks ago in my Southeast D.C. pediatrics clinic, I noticed my last patient was a 16-year-old for an asthma follow up visit. Before walking in, I reviewed her medical history and current asthma medications, which would guide my future medical management. However, when I walked in, I found a tearful and terrified teenage girl. She and her boyfriend had unprotected sex seven weeks prior, and she is now concerned she may be pregnant. Her concern bore truth. She felt alone and afraid sitting on a cold exam table.
 
She decided that together we would tell her mother who was patiently waiting outside. After breaking tough news numerous times as a pediatrician, one would think it gets easier with time. It doesn’t. The emotionally charged conversation ended with a brave young woman and her family facing an incredibly personal and immense decision – what reproductive health steps should they take next?

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There is no topic in the United States that is more divisive as abortion rights and access. According to a 2015 Gallup poll, the nation is fairly evenly split with 50 percent of the public ‘pro-choice’ and 44 percent ‘pro-life’. And those numbers were the exact opposite in 2012. This topic has been the target of presidential campaigns, Supreme Court nominations, and millions of dollars of attack ads.

Though a deeply personal issue, this public debate has created a friction and a gulf between Americans, making it seem as though we are more different than alike. The labels by themselves lead to inaccuracy; is anyone truly against life or choice in our society? 

Thinking back about my patient, I believe there is something that most if not all of us can agree on. We would prefer for her not to have an unintended pregnancy in the first place. Unfortunately, her situation is not unique. About half of the annual 6.7 million pregnancies in our country are unintended. Of those, 43 percent end in abortion. Preventing unintended pregnancy is the key and should be a bipartisan rallying cry.

So how do we do that? There are a few options that are not great, and a couple that are near perfect. Abstinence, by definition, can 100 percent prevent pregnancy, but abstinence only sex education has shown the opposite effect of increased teen pregnancy. Nearly one in five unintended pregnancies occur in the first year of typical condom use. In practice, birth control pills are 93 percent effective, which is good but not great.

Luckily there is a silver bullet. Long acting reversible contraceptives (LARCs) are safe, nearly 100 percent effective, and cost effective. LARCs include intrauterine devices (IUDs) as well as implantable birth control. Introducing LARC options to school based health clinics in New York City helped reduce its unintended teen pregnancy rate by over 25 percent.

In order to prevent unintended pregnancies and subsequent abortions, we must expand LARC access. That means full contraceptive access in pediatric clinics, high schools, colleges, non-profits, and community centers. That means our federal and state policies should be aimed to expand contraceptive access, not reduce it. That means not repealing the Affordable Care Act’s guaranteed access to contraceptive management. That means understanding Planned Parenthood provides more preventative reproductive care and birth-control access than abortion services. For my patient, earlier LARC access means I may have actually ended my day with that asthma follow up visit.

Dr. Shah is Pediatrician and the Vice-President of the D.C. Chapter of the American Academy of Pediatrics.


The views expressed by authors are their own and not the views of The Hill.