BOULDER, Colo. — “I need her to know we should be careful. Birth control. Find out what’s right for you.”
That’s the message from a man wearing a fedora and holding a guitar over his briefs — all he’s wearing — on the Beforeplay website.
The site is just one part of Colorado’s multifaceted campaign to encourage the use of birth control, especially long-acting birth control such as IUDs and hormonal implants. State officials say the program has lowered the incidence of abortion and teen pregnancy.
But access to long-acting birth control has been a major issue in Colorado’s heated midterm election races. For the third time, Christian nonprofit Personhood USA is advocating an initiative on Colorado’s ballot that would define life as beginning at conception — potentially preventing women from accessing the contraception that the birth control campaign is promoting.
In recent years voters have overwhelmingly defeated two other “personhood” initiatives. But the background to the birth control debate changed this year when crafting retailer Hobby Lobby won a Supreme Court case to preclude offering insurance policies that covers birth control the company cited as “items that risk killing an embryo” — including IUDs.
And the dispute over long-term birth control like IUDs and hormonal implants — which have been recommended by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists for teen girls because they’re more effective at preventing pregnancy than birth control pills — is ramping up in Colorado’s heated races for the U.S. Senate, the 6th Congressional District and governor.
State officials say the privately funded but state-operated Colorado Family Planning Initiative, which includes the Beforeplay website, is reducing teen pregnancy and abortions.
But some candidates and activists on both sides appear to be painting the debate in broader, dramatic strokes, avoiding specifics of what does and doesn’t scientifically constitute abortion, despite the success of the long-term contraception program.
Reproductive health experts say the belief that emergency contraceptives and IUDs cause abortions is in direct opposition to the widely established scientific definition of pregnancy. But at a recent debate a Republican gubernatorial candidate called IUDs an “abortifacient.”
While birth control pills are considered effective 90 percent to 95 percent of the time, with failure often resulting from women forgetting to take the pills, IUDs are considered 99 percent effective.
Traditionally, birth control at Colorado’s reproductive health clinics has meant pills prescribed for daily use, with price being the main reason long-acting birth control methods were less commonly used. Inserting an IUD or a hormonal implant is an in-office procedure that may cost $500 or more. The methods last five to 10 years, and fertility returns as soon as the IUD is removed.
“They are expensive methods up front,” said Susan Levy, executive director of Boulder Valley Women’s Health. “We can’t afford to fully subsidize them.”
That’s where a grant program operated by the Susan Thompson Buffett Foundation came in. It paid for the program in Boulder, then expanded it to other Colorado clinics in 2008. Since 2007, when the program was instituted, the number of abortions performed declined 17 percent at Boulder Valley Women’s Health.
Statewide, teen pregnancy in Colorado dropped 40 percent from 2009 to 2013, when 68 family planning clinics participated in the program. State officials say the teen abortion rate dropped 35 percent in counties with the program.
“We are a very rural area, and we have a lot of undocumented families, migrant families,” said Erlinda Deluna, family planning coordinator for Valley-Wide Health Systems in Alamosa, which receives funding from the program. “Low-income, very low-income economy around here — or no income.”
She said the teen pregnancy rate there is on the decline, which she attributes to the availability of long-acting reversible contraception like IUDs.
“A lot of folks want birth control, but they can’t really afford it,” Deluna said.
Despite the prior opposition to the “personhood” bills and the success of the long-term contraception program, access to birth control has become a political hot-button issue in Colorado this year.
Women are considered a key constituency among the swing voters who will decide Colorado’s Senate race — and potentially control of the Senate.
When Republican Rep. Cory Gardner decided to challenge incumbent Democratic Sen. Mark Udall earlier this year, he reversed a key position on birth control in his first month in the race.
Gardner supported the 2008 and 2010 efforts to insert “personhood” into the Colorado Constitution, initiatives that were defeated by 70 percent of voters.
But in March he told The Denver Post he no longer supported the “personhood” initiative, saying he didn’t realize it could ban some forms of contraception.
Yet Gardner is a co-sponsor of the federal Life at Conception Act, a House bill considered the equivalent of “personhood” bill. When asked about the bill in a September interview on Denver’s Fox 31, he repeatedly replied, “There is no federal ‘personhood’ bill.” But he signed on to sponsor the federal Life at Conception Act in July 2013 and hasn’t withdrawn his sponsorship. His campaign didn't return a request for comment.
And now Gardner is advocating making birth control pills available without a prescription, a position he outlined in a June Denver Post op-ed. Other Republican candidates around the nation have followed his lead, saying it would make birth control less expensive for women. Udall’s spokesman Chris Harris told Al Jazeera that Udall would support over-the-counter pills if insurance still covered the cost.
Television ads on the Senate race focus heavily on birth control and abortion, with Udall and his allies saying Gardner’s views would potentially threaten long-term birth control, while Gardner attacks Udall frequently on his vote in favor of the Affordable Care Act, which Gardner has voted repeatedly to repeal.
Gardner’s about-face has alienated him from some “personhood” supporters.
“It’s very confusing to me as a young conservative voter,” said Jennifer Mason, 31, a spokeswoman for Personhood USA who lives in Denver. “I’m seeing a lot of the conservative candidates picking up Democratic talking points and Planned Parenthood talking points, talking about pills being available over the counter.
“They’ve certainly lost my vote on that, and I’m sure they’ve lost other votes as well.”
Gardner continues to describe himself as “pro-life” and an opponent of abortion. And Planned Parenthood Votes Colorado, the health care provider’s political arm, criticized the Post’s endorsement of the Republican, citing the candidate’s “desperate attempts to hide his record and agenda for women’s health.”
Colorado's family planning initiative also became a subject of dispute at a Sept. 30 gubernatorial debate when Democratic Gov. John Hickenlooper’s Republican challenger, former Rep. Bob Beauprez, said he believes an IUD causes a fertilized egg to be aborted. He told the Post that he would oppose taxpayer funding for such contraception.
In early July, Hickenlooper hailed the results of Colorado’s program at a news conference.
And the group supporting Amendment 67, this year’s Colorado “personhood” initiative, tweeted commendations to Beauprez: “Great to see a candidate for governor come out against abortion-causing IUDs.”
Neither campaign responded to a request for comment.
Some anti-abortion groups, however, are not in support of the “personhood” initiative. Sarah Zagorski, director of anti-abortion group Colorado Citizens for Life, declined to voice an opinion about long-acting birth control methods.
“We’re just trying to focus right now on common-sense legislation [against abortion],” Zagorski said. “Our organization doesn’t take a stand on birth control at all.”
Colorado Citizens for Life President Steven Ertelt told The Denver Post that the organization didn't support the initiative because even if it passed, it would be overturned as contravening Roe v. Wade.
“The whole thing is nonsense,” Levy said. “It’s just an opportunity to use this to rally troops for political beliefs. If they’re deeply opposed to any contraceptive methods, they need to be up front about that.”