Colorado Debates Whether IUDs Are Contraception Or Abortion

Mar 5, 2015
Originally published on March 8, 2015 7:21 pm

A popular contraception program in Colorado is receiving criticism from conservative lawmakers who say that the program's use of intrauterine devices, or IUDs, qualify as abortions.

More than 30,000 women in Colorado have gotten a device because of the state program, the Colorado Family Planning Initiative. An IUD normally costs between $500 and several thousand dollars. Through the program women could receive one for free.

This is because the program received a $23 million private grant in 2009 that has covered all its costs until now. To keep going, a group of bipartisan lawmakers are trying to push a bill through the Colorado Senate. But they're running into problems because of restrictions on what the state can and cannot fund.

State health director Larry Wolk says that the program has largely been a success. "Our teen birth rate has dropped 40 percent over the last four years," says Wolk. "The decline in teen births has been accompanied by a 34 percent drop in abortions among teens." A study published in Perspectives on Sexual and Reproductive Health credited the changes to the free contraceptives.

Fewer abortions should mean success for liberals and conservatives alike, right? That's what Republican state representative Don Coram, who's sponsoring the bill, thinks. He says that the program saves state money because it decreases the number of births Medicaid covers and lowers the state's enrollment in welfare. "If you're anti-abortion and also a fiscal conservative, I think this is a win-win situation for you," Coram says.

But not everyone agrees, because of how IUDs function. Most of the time an IUD prevents sperm from meeting an egg, and therefore prevents pregnancy. But if the egg and sperm do meet, the IUD keeps that embryo from planting itself in the uterus. In those cases, an IUD would prevent a fertilized egg from developing into a person.

"This crosses a line," says Republican Kevin Lundberg, who chairs the Senate Health Committee in Colorado. In Lundberg's view, an IUD can count as an abortion, and this makes it impossible for a program that funds IUDs to receive state funding. "The state constitution says no direct or indirect funding from the state shall go towards abortion," Lundberg says.

Private funding for the program ends in June of this year, so lawmakers have just three months to work out their differences.

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A Colorado program that supplies low-income women with contraception is being credited with a major drop in the state's abortion rate. But funding for the program is being challenged by some conservative lawmakers. As Megan Verlee of Colorado Public Radio reports, they don't like the type of birth control being offered.

LAURISA RODRIGUES: This is actually - where did it go? This is kind of our demo for the IUD.

MEGAN VERLEE: Health educator Laurisa Rodrigues digs through a box of medical equipment in her office at the Pueblo Health Department's Family Planning Clinic. She pulls out a slightly battered-looking intrauterine device and a plastic model of the female anatomy.

RODRIGUES: So I kind of just go over that, you know, when you come in this is what happens. Jan will insert that, it goes in your uterus, you know...

VERLEE: Pueblo County fits around six women a week with free IUDs. Over the last five years, more than 30,000 women in Colorado have gotten the devices thanks to a state program. It provides counties with long-acting, reliable contraception - implants and IUDs - and trains clinic staff on how to administer them. According to state health director Larry Wolk, the results have been dramatic.

LARRY WOLK: Our teen birth rate has dropped 40 percent over the last four years. The decline in teen births has been accompanied by a 34 percent drop in abortions amongst teens.

VERLEE: Wolk was testifying in support of public funding for the contraception program. A private grant covered all the costs up until now, but that money is running out. So a bipartisan group of lawmakers want the state to keep the effort going. Republican Representative Don Coram is sponsoring the bill.

DON CORAM: If you're anti-abortion and also a fiscal conservative, I think this is a win-win situation for you.

VERLEE: Coram says the program will save the state money from fewer Medicaid-covered births and lower welfare enrollment. But his support of the program puts him on a collision course with some other abortion opponents in his party. Republican Kevin Lundberg chairs the Senate Health Committee, which is likely to consider the bill.

KEVIN LUNDBERG: Article V, section 50 of the Colorado constitution says no direct or indirect funding from the state shall go towards abortion. This crosses the line.

VERLEE: The line Lundberg is talking about is when life begins. Generally an IUD prevents sperm from meeting egg, but if that fails, it can keep a fertilized egg from implanting in the uterus. To the medical community, that stops a pregnancy before it can start. Many in the anti-abortion movement believe life begins at the moment of fertilization. So, Lundberg says anything after that that prevents a fertilized egg from continuing to develop counts as an abortion.

LUNDBERG: The IUD is a mechanical device that makes it an impossible environment for a young child to implant in the uterine wall.

VERLEE: In recent years, some in the anti-abortion movement have shifted their tactics from trying to outlaw abortion directly to defining the beginning of life, and that has changed the anti-abortion conversation. Mississippi College law professor Jonathan Will studies personhood laws.

JONATHAN WILL: Because the language is drafted broadly, you got much more discussion about these more specific issues regarding everything ranging from contraception to IVF.

VERLEE: And for some abortion opponents in Colorado, that discussion is now focused on whether they can live with more women using contraception they object to if the result is fewer abortions. For NPR News, I'm Megan Verlee in Denver. Transcript provided by NPR, Copyright NPR.