On Reproductive Choice: The faith difference between Melinda Gates and Amy Coney Barrett and what that means for women

I recently finished Melinda Gates book, “The Power of Lift”, and was most impressed by the intersection of her strong Catholic faith and her views on reproductive choice. The Catholic church is often seen in sharp disagreement with not only abortion but also the use of contraception. Ms Gates acknowledges this dissonance and then lays out a thoughtful argument as to why she is able to honor her Catholic faith while at the same time using her platform and funding thru the Gates Foundation to increase access to contraception that enables women to make informed decisions about whether and when to have children. It has been proven that spacing of pregnancies reduces maternal and newborn deaths as well as increases the health of children already in the family.

Foremost, Gates admits that it is not only difficult but also misogynistic for a celibate male hierarchy to be allowed to make decisions about the reproductive life of woman when these same rules can harm the mothers and the children they birth by perpetuating the cycle of poverty. It is her empathy with poor women and children, per the Franciscan teachings of the church, that has led her foundation to provide funding for innovative contraceptive options as well as increased access to these options. Thru her travels in the developing world, she came to understand that contraception prevented millions of unsafe abortions by preventing unwanted pregnancies. While 93% of Catholic women in the US have used contraception, the Catholic church was working to prevent women outside of the US from having those same choices.

Amy Coney Barrett is also Catholic but has chosen to use her faith as a way to limit reproductive options for women in this country. If she becomes the next Supreme Court Justice she may be the deciding vote in overturning access to legal abortions. Even more timely are her views on the Affordable Care Act and what that means for women and their reproductive health. Prior to the ACA, women were required to pay for contraception and could be charged more for health insurance as having babies is a costly endeavor. After the ACA was passed and the more reliable, but costly, long term contraceptive options became available for free, unintended pregnancies and teen pregnancies plummeted and the abortion rate hit its’ lowest point, dropping 14%.

Ms Barrett has a developing world example in her own home. Two of her children are adopted from Haiti. Abortion in Haiti is illegal and reliable contraception difficult to obtain. Poverty is endemic as is the role of men in controlling women’s lives. When women are unable to feed their growing families, they often place a few of their children in a religious sponsored orphanage with the intent that “when my situation improves, I will go back and get my children”. Most of these mothers are never reunited with their children because their poverty does not improve.

I have worked intermittently in Haiti as an ob/gyn physician since 2006. Some of the most horrific situations I have encountered are when desperate woman seek an illegal abortion. The maternal mortality can be exceedingly high when unskilled providers perform medical or surgical abortions. This may be the future of our country if we restrict access to contraception at the same time that we make abortion illegal.

Religious faith can be a powerful force for doing good, as evidenced by the work of Melinda Gates and her leadership in increasing access to contraception, which she believes, and has been factually proven, to lift women out of poverty. . It can also be a force that demonizes the tragic choices that women in poverty sometimes have to make in order to support their children. That is the faith of Amy Coney Barrett.

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