A Medical Briefing
in Opposition to S. 104 (EPICC)

prepared by:

Dominic Pedulla, MD, FACC, CNFPMC
Fellow of the American College of Cardiology
Creighton Natural Family Planning Medical
Consultant

The Edith Stein Foundation
3366 NW Expressway, Bldg. D #630
Oklahoma City, OK 73112
Phone: (405) 715-9900 Fax: (405) 947-2307
E-mail: edithstein@worldnet.att.net

A Disastrous "New Social Norm" (How EPICC Would Threaten Women's Health and Reproductive Freedom)

Many of us in the various women's health and family planning specialties are alarmed about S. 104, the "Equity in Prescription Insurance and Contraceptive Coverage Act of 2001" (EPICC) bill being considered in the Senate. Essentially the bill would require all health plans to cover prescription contraceptives (the pill, IUD, Norplant, Depo-Provera, diaphragm, and so-called "emergency contraception") as well as outpatient contraceptive procedures, as a "basic health care right" for women. In support of this bill, various testimonies were given on Sep. 10, 2001 before Sen. Barbara Mikulski, who chaired the committee for Sen. Kennedy. (1)

The most important argument advanced by proponents of the bill is the "unintended pregnancy" argument. Dr. Anita Nelson, representing the American College of Obstetricians and Gynecologists, testified that 50 percent of U.S. pregnancies are unintended, and that 50 percent of these unintended pregnancies are aborted. Thus she urged the Senate to mandate coverage in the belief that prescription contraceptives can solve this problem. A lesser argument centers on alleged "noncontraceptive health benefits" of prescription contraceptives. This argument alleges that oral contraceptives are associated with reduced rates of certain diseases and therefore improve women's health apart from their contraceptive effects. (2)

What does "unintended pregnancy" mean?

Increasingly researchers question the meaning of "unintended pregnancy". Noting a troublesome subjectivity, changeability, and arbitrariness, few researchers agree on the definition of the terms "unintended", "unwanted", "mistimed", and "unplanned". The most prominent of these researchers are now calling for more careful study of this confusing question, especially before any practical policy decisions are made. (3) The EPICC bill would be a classic case of imprudent policy if based on this elusive concept. Why would the Senate take precipitous action based on such an ill-defined term, when the experts cannot agree as to what it means?

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