The Problems of Contraception
[Bertha] Barnes was on birth control pills, but gave them up because of high blood pressure. When she went to a Galveston clinic to be fitted for an intrauterine device, she was told that their schedule was full. When her contraceptive foam ran out, she did not have the $5 for a new supply. That is when she became pregnant.
steven Roberts, New York Times
Abortion and contraception are not simply alternatives. They are, as family planning specialists tell us, complexly interrelated, even interdependent. After all, the main reason why women require abortions is because contraceptive methods fail—in many ways, not only the obvious ones. From the standpoint of a woman seeking to avoid pregnancy, a method "fails" when she errs in its use or the method is flawed or too expensive and when its risks or side effects, or its irreversibility, make its costs prohibitive to her. In the latter case the method fails because it does not meet her basic needs, which include the need to maintain her essential health and well-being and, perhaps, to keep her options about future childbearing open.
Physicians and family planners place priority on technical "efficacy" in evaluating contraceptive methods in a way that sometimes minimizes or denies women’s concerns about their health and personal needs. At first glance, they would seem to have both the historical and public health records on their side. As we have seen, women have repeatedly chosen to risk their health, sometimes their lives, to achieve effective fertility control. Moreover, for women in certain age and socioeconomic groups or with specific health problems, carrying a pregnancy to term is no doubt more hazardous than taking the pill.1 Nevertheless, the social context of the 1970s was one in which the idea of health as a basic right and the activism of feminist health advocates and Third World liberation groups transformed the discourse of reproductive rights politics. In part, this was possible because of the availability of abortion, which altered the basic terms of reproductive choice and risk. In the current framework, the "choice" between effectiveness and safety, or between effectiveness and future fertility, is no longer politically tolerable. At the same time, the tension in women’s experience and in feminist thought between the desire for control and the desire to minimize, or socialize, risk remains. In the area of contraception, it is especially intense.