Norplant: Paternalism or Choice?

January 30, 1993

Norplant, the five-year contraceptive implant, has been used by almost 2 million women around the world -- by choice. But the safety, convenience and reliability that have made it popular also present the temptation to turn choice into coercion. Almost from the moment Norplant was approved for use in this country in 1990, the suggestion has been raised from time to time that government consider requiring certain women to use the device.

In his State of the State address last month, Gov. William Donald Schaefer added the latest chorus by suggesting that his new Welfare Policy Commission take a look at all the possible solutions, extreme or not, to reduce the number of children being born to women and girls who are not able to take care of them.

That included, the governor said, the possibility of requiring women to use Norplant or requiring men to have a vasectomy if they are on welfare and have a number of illegitimate children.

Predictably, only a few days after the speech, a group of ministers in East Baltimore began to raise questions about the city health department's efforts to make Norplant available to women who choose to use it but can't afford it. The ministers worried about side effects on black teen-agers and raised questions about coercion or even conspiracies to prevent African American or poor women from having babies.

That kind of reaction helps to illustrate what's wrong with "taking a look" at any suggestions of coercion in matters of contraception.

For the same reasons we support a woman's right to a safe and legal abortion, this newspaper believes contraception should always be a matter of choice, never coercion -- and not paternalism. Moreover, those issues obscure the real issues surrounding Norplant -- accessibility and, especially, affordability.

Norplant costs about $350, plus a fee for insertion. For five years of contraceptive protection, that may not be an exorbitant cost, but it is more than many women can afford all at once.

In fact, the governor's musings about coercion diverted attention from his commendable plan for a family planning initiative that would allow 2,350 Maryland women to obtain Norplant. There are plenty of women in Maryland who want Norplant and can't afford it.

Ministers should be concerned about their congregations. But in their effort to criticize suggestions of coercion, they are veering into paternalism. They should applaud any program that attempts to give poor women the same choice many affluent women have eagerly embraced.

In matters of contraception, the goal should be choice -- not coercion or paternalism, however benevolent the intent.

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