Good afternoon,
As public health professionals, we have the responsibility to advocate for populations that may not have
the education or resources to advocate for themselves. Adolescent girls and young women who have
unplanned pregnancies are groups benefitting from this advocacy. There are often ethical dilemmas
surrounding how contraception is handled. When ethics are involved, the program must prove it
effectively achieves the goals it states it will accomplish.1 For this reason, I have chosen the prevention
of unplanned pregnancy as the Centers for Disease Control and Prevention (CDC) 6 |18 Initiative to
investigate further.2
Analysis by the CDC finds that roughly half of United States (US) births every year are unplanned,
creating an astronomical cost for public insurance companies, over $12,000 per birth. Consequently, the
CDC created the initiative to provide evidence and promote interventions for the continued use of public
insurance to reimburse contraception, improve the availably of contraception options to providers, and
remove some of the barriers to accessing long-acting reversible contraception (LARC).2 Ensuring
providers have access to quality evidence about what types of contraception are available and how
reimbursement works gives them the tools to thoroughly and correctly counsel their patients. The
continued availability of publicly funded contraception is what allows for the prevention of the millions
of unplanned pregnancies that we see each year in the US, and analysis of this initiative reveals that it is
a worthwhile effort. Not only are unplanned pregnancies expensive for the government, and potentially
the mother, but they also correlate to worse outcomes for both the infant and the mother.2
Evaluating the current system, we find that providers are reimbursed for contraception, but not the full
scope of contraceptive services.2 Comprehensive sex education has been shown to reduce the rates of
teen births, which means abstinence education, contraception, and social support all play a role in the
prevention of unplanned pregnancies.3 The initiative provides a concise location showing the need for
more comprehensive family planning services to appeal to insurance payers and providers. When it
comes to the prevention of unplanned pregnancy for women eligible for Medicaid, it only takes one
dollar of public funding to save over four dollars on infant and maternity care!2 Additionally, while LARC
options such as IUDs have a higher cost upfront, by year three there are significant reductions in both
cost and unplanned pregnancies when compared to short-term contraception options that are cheaper
upfront.2
There is no one-size-fits-all model for the prevention of unplanned pregnancies. A key factor when
justifying this initiative is to note that it is not an attempt to end unplanned pregnancies but to help give
providers the evidence and give patients the resources to make safe, informed choices on the prevention
of them. Government-funded contraception is a touchy topic for many individuals and political or
religious groups, especially for Christ followers. If someone feels the use of contraception, particularly for
pre-marital sexual relations, contradicts God’s plan for His children, it heavily impacts their willingness to
support programs, taxes, or businesses that fund it. This is a scenario where justification must come from
evidence as public health is walking the line between improving the health of a population and the
perception that individual liberties are being compromised.1 The CDC presents both financial and health
factors for this initiative and adequately addresses some of the burdens of those factors, making this a
well-justified initiative.1,2
Romans 1:32 is a verse that comes to mind as to why someone may oppose initiatives such as this one.
After giving a laundry list of sins Paul states are deserving of death, he then states that death is deserved
not only for those who commit the sins but also for those who approve of them.4 That is a heavy weight
to consider! Public health professionals with a Christian Worldview are faced with the moral dilemma of
determining if the higher importance falls on helping correct a pressing social issue or on determining if
an issue is sinful or not.
References:
Kass NE. An Ethics Framework for Public Health. American Journal of Public Health. 2001;91(11):1776-
1782. doi:https://doi.org/10.2105/ajph.91.11.1776
CDC. Prevent Unintended Pregnancy | 6|18 Initiative | CDC. www.cdc.gov. Published February 13, 2019.
https://www.cdc.gov/sixeighteen/pregnancy/index.htmLinks to an external site.
Mark NDE, Wu LL. More comprehensive sex education reduced teen births: Quasi-experimental
evidence. Proceedings of the National Academy of Sciences. 2022;119(8).
doi:https://doi.org/10.1073/pnas.2113144119
The Holy Bible : ESV. American Bible Society; 2007.
Read Less
Powered by TCPDF (www.tcpdf.org)
