Slowing Population Growth Humanely: LARCs Reduce Abortions, Poverty –and Up Savings

Harte, Mary Ellen | May 22, 2018 | Leave a Comment Download as PDF

uterine armor by +mara | flickr | CC BY-NC-ND 2.0

Though both population growth and consumption have been identified as the two main factors fueling most of our global problems, far more attention has been focused on solving consumption, especially of energy, than attaining sustainable population levels humanely via, initially, slowing population growth. Doing so within the country of highest consumers, the United States, would set a positive model for developed countries, and our planet. Similarly, doing so within its largest state economy (and fifth largest economy in the world), California, would set a positive model for the rest of the nation to follow.

How? Prevent unintended pregnancies. Unintended pregnancies comprise roughly half of all human pregnancies worldwide, and roughly 45 percent of all U.S. pregnancies, resulting in a significant number of births.

The relatively recent development of cost-effective LARCs (Longterm Active Reversible Contraceptives in the form of implants and intrauterine devices) makes this goal far more possible. LARCs can last three or more years with negligible maintenance, and are over 10 times more effective than standard contraceptives, a 2012 New England Journal of Medicine study shows. The American Congress of Obstetricians and Gynecologists in 2009 recommended LARCs for most U.S. women as a first line defense against unintended pregnancies. The Center for Disease Control now promotes LARCs to prevent unintended pregnancies.

Conversely, the Trump administration is pushing abstinence-only teen pregnancy programs, not even mentioning contraception in its recent family planning guidance document, and showing no signs of renewing federal contraceptive funding via Title X clinics –the latter of which, if absent, will seriously impact California family planning. Title X funding is a major pipeline for supplying contraceptives to low income families in California via the Family Pact Program, which services over 1 million people annually.

Yet, a 2014 Guttmacher Institute demographic analysis shows that the main driver behind dramatically declining teen pregnancy rates over recent decades is more and better contraceptive use. Abstinence-only education has been shown to be useless in preventing pregnancy and may even worsen the problem among adolescents, whose developing brains often make flawed decisions. When unintended pregnancies decrease, so do abortions, a 2016 Guttmacher policy analysis shows.

Congressional Republicans keep pushing to limit family planning providers specifically to low income  women –precisely the demographic group, between 20 and 40 years of age,  most vulnerable to unplanned pregnancies, a 2016 National Institute of Health demographic analysis shows. Limiting access to family planning runs counter to Republican opposition of abortion. A 2017 Guttmacher Institute demographic analysis shows that when women have greater access to effective contraceptives, both unplanned pregnancies and abortions decrease. LARCs could be the winning tool to resolve this mismatch between position and policy.

A 2014 Brookings Institute report on childhood poverty proposed marketing LARCs specifically to low income women. Escaping poverty is challenging. An unplanned birth is likely to keep a poor woman in lifelong poverty, as she expends scarce resources on child rearing instead of self-improvement. Tragically, poverty can cut women’s average lifespans up to 20 years or more, a 2017 Journal of the American Medical Association study shows. Thus, inadequate access to contraceptives can deprive women of decades of life.

The resulting increase in poverty increases economic burdens on communities. Poverty is a big problem in California, with roughly one in seven persons living in poverty. It affects us all, including businesses, which need customers. Already stressed budgets at every level of government must address yet more costs associated with expanding public programs to serve low income populations. With already unsustainable human growth on this planet, extra births further worsens the problems of yet more unsustainable consumption, pollution, and climate change, which, a recent Los Angeles Times article noted, will seriously impact California agriculture.

It’s time to cut U.S. costs and losses, both human and economic. U.S. family planning yields seven saved dollars for every dollar spent, a 2014 Guttmacher Institute analysis shows.  A 2007 National Health Institute study showed how California saved over 1.5 billion dollars from a single year of averting unplanned pregnancies. The Colorado state government reports that easy access to LARCs results in annual savings of several millions of taxpayer dollars. Investing in easy access to LARCs, especially for poor women, offers Republicans many wins: economic savings, eliminating most abortions, and growing prosperity. The choice is theirs: Trump and the GOP have the opportunity to create an incredible legacy of progress, or hypocrisy.

The Republican dominated federal government, however, is unlikely to supply Democrat-dominated California the funding needed to promote LARCs to those women who need them most, supply the LARCs, and train the personnel needed to implant them. Yet, the sheer economic savings makes it a pragmatic investment for California, as well as the rest of the world, the 2018 Guttmacher-Lancet Commission Report notes. Convincing California’s state government and private entities to invest in creating this profitable model of slowing population growth could bring about a cascading shift in how the United States, and the rest of the world views attaining sustainable population levels humanely.

Mary Ellen (Mel) Harte Ph.D. is a biologist who writes on climate change and population issues. She co-authored the free downloadable book, Cool the Earth, Save the Economy, at Cool the Earth, and produced the weekday “Climate Change Report,” 90-second audio newscasts, as well as the Climate Change Reports blog.

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