More on the Contraception Controversy

The last three blog posts have linked to articles regarding the controversial new rule enacted by the Obama administration that a number of faith-based organizations would have to include coverage of contraception in their employees' health insurance, and the subsequent compromise on the issue (that insurers will have to provide this coverage for free if a faith-based organization objects to paying for it on legal grounds).  Some were assuaged by the compromise, while others were not.  The Economist writes that this appears to be a battle between the fringes, since most moderates aren't particularly upset.

The Catholic Bishops, however, aren't backing down.  Here's what they had to say about the White House's arguments for the plan and here's their central page on the issue.  Meanwhile, one liberal blogger argues that Obama came out too well in the end not to have planned this from the start, writing that

The fun part of this is that Obama just pulled a fast one on Republicans. He drew this out for two weeks, letting Republicans work themselves into a frenzy of anti-contraception rhetoric, all thinly disguised as concern for religious liberty, and then created a compromise that addressed their purported concerns but without actually reducing women's access to contraception, which is what this has always been about. (As Dana Goldstein reported in 2010, before the religious liberty gambit was brought up, the Catholic bishops were just demanding that women be denied access and told to abstain from sex instead.) With the fig leaf of religious liberty removed, Republicans are in a bad situation. They can either drop this and slink away knowing they've been punked, or they can double down. But in order to do so, they'll have to be more blatantly anti-contraception, a politically toxic move in a country where 99% of women have used contraception.

One of the controversies surrounds a figure cited by the White House, columnist Nick Kristof, and others that (various people have repeated it differently) 98% of Catholic women use contraceptives (Kristof writes that "A national survey found that 98 percent of sexually active Catholic women use birth control at some point in their lives.") The figure is less than precise for a number of reasons -- here's one blogger's dissection of, and response to, the 98% figure.  And here's another blog post by a conservative commentator highlighting some limits to the data.

Here's Politifact's evaluation of the 98% figure (they declared it "mostly true"). And here's the (very short) report from which the 98% figure came.

The report unambiguously declares that "Among all women who have had sex, 99% have ever used a contraceptive method other than natural family planning. This figure is virtually the same, 98%, among sexually experienced Catholic women" (p. 4). But it's unclear that the data support that authors' assertions, for a number of reasons -- two of which are particularly important.

1.) The difference between "sexually experienced" and "sexually active". The authors use the former phrase in the quote I pasted above, but the rest of the article and the table they seem to refer to in that quote all describe "sexually active" women -- those "who had sex in the three months prior to the survey" (p. 8).  And, actually, it doesn't even include all sexually active women, since it excludes those who are "pregnant, postpartum, or trying to get pregnant," labeling the women included as "women at risk for unintended pregnancy" (p. 8).  So, it seems like the 98% stat should actually have been written something like "98% of Catholic women between ages 15-44 who've had sex in the past three months and are not pregnant or trying to conceive used a form of birth control other than natural family planning in that same period".

2.) 11% of the women who report using methods other than "natural family planning" used "no method,"  And 4% use "other methods," which mainly includes withdrawal "but also includes less common methods, such as suppositories, sponges and foams" (p. 8).  I'm unclear on precisely what these 15% of women are doing to prevent pregnancy and how, exactly, that aligns with the teaching of the Catholic church, but it seems that the number of sexually active Catholic women who are at risk of unwanted pregnancy and are using non-approved methods of contraception is somewhere between 83% and 98%.  I'm skeptical that any of the 11% using "no method" belong in there, but it sounds like some of the 4% using "other" do.

The problem, of course, is that the most important stat would be the percentage of Catholic women who, at some point during their childbearing years, use contraceptive methods not approved by the Catholic church.  To get that figure, we'd have to survey a large group of women who are at least 45 and ask them what types of contraceptives (if any) they've used (though given that it could change by generation, we could also survey younger women about past use and future intent and calculate total likelihood).  The 83-98% number does not represent that figure, even though that authors seem to imply that it does.  We can, however, guesstimate what the figure might be.

If one uses the most conservative estimates -- assuming those who are not sexually experienced or are pregnant, postpartum, or trying to conceive (the latter group is 14% of married women, the report says) have never used, and will never use, non-sanctioned contraceptives -- then we might guess that only about 50-60% of Catholics ever use these.

On the other hand, more realistic estimates would account for the fact that many of those who are excluded from the sample (the non sexually active and the pregnant/postpartum/attempting to conceive group) and many of those 2-17% who aren't currently using non-sanctioned contraceptives either have used or will use these devices at some point in time (perhaps when they were younger and didn't want children or when they grow older and become sexually active and/or don't want any more children).  Taking those factors into account, a more realistic guesstimate would be that somewhere in the neighborhood of 90% of Catholic women use some method other than natural family planning or "no method" at some point in their lives.  But those are only guesstimates that are loosely informed by the data.

The moral of the story is to never take stats at face value -- not even the descriptions used by trained researchers, and certainly not the parroting of these findings by reporters.