JUNE SIMMS: Welcome to THIS IS AMERICA in VOA Special English. I'm June Simms.
BOB DOUGHTY: And I'm Bob Doughty. Birth control is usually a private issue. This week on our program, we look at some of the reasons why this issue has been getting a lot of public attention recently in the United States.
JUNE SIMMS: Peter, Chris, Lisa and Patty are college students here in Washington. They all attend George Washington University. They also have something else in common. They are all Catholic. They share the belief of the Roman Catholic Church that using contraception to prevent new human life is morally wrong.
Peter -- we'll just use first names -- says he knows that belief puts him and his friends in a minority in the popular culture around them.
PETER: "I believe that our generation -- my generation -- has been brought up with a different form of family planning than our parents, than our grandparents. My mother's one of nine. I'm an only child. We were taught, 'Do you want to have that many kids?' Sort of pushed: 'Do you want to plan how many kids you have?'"
BOB DOUGHTY: Chris agrees. He remembers what he was taught at the public high school he attended in New Hampshire.
CHRIS: "The way they taught it was, the only way that you can definitely not get pregnant and not get an STD is to be abstinent. They also told you how to have -- quote, unquote -- safe sex."
In other words, Chris feels he got conflicting messages. Students were taught that they could avoid pregnancy and sexually transmitted diseases by avoiding sex. But at the same time they were also taught how to have so-called safe sex, like using condoms.
JUNE SIMMS: Different states have different requirements for offering sex education or "family life education" in public schools. Lisa grew up in a relatively conservative city in Colorado. Her teachers were not required to discuss contraception. Instead, she says they talked a lot about the importance of not having sex until marriage.
But Lisa says in popular culture, girls are often told they should go on birth control pills for reasons other than preventing pregnancy.
LISA: "'Birth control's the answer to everything.' You have a pimple? You get birth control. You have a bad cramp? You get birth control. It's the answer to a lot of things for girls. You're just annoyed and someone's like, 'Oh, just go get birth control.'"
Patty still remembers being shown images of untreated diseases when she was learning in school about the risks of having sex.
PATTY: "I remember we had to watch a lot of videos in my health class and -- ugh!"
BOB DOUGHTY: But teenagers appear to be paying attention to those warnings about STDs and lessons about sex education.
For most of the past twenty years, teen birthrates in the United States have fallen. The latest government report shows that the birthrate for teens age fifteen to nineteen fell to a record low in twenty-ten. There were thirty-four births for every one thousand teenagers. That was the lowest rate in almost seventy years of keeping records.
The Guttmacher Institute is a research and policy organization that works on sexual and reproductive health issues. It says nearly half of all pregnancies in the United States are unplanned. And of these, about four in ten are ended by abortion.
Abortion rates began falling in the nineteen eighties. However, the rate of decrease slowed to a halt between two thousand five and two thousand eight, the most recent years available.
The Guttmacher Institute says nearly fifty million abortions took place between nineteen seventy-three and two thousand eight. Nineteen seventy-three was the year the Supreme Court decided that women have a legal right to abortion.
Three years earlier, Congress and President Richard Nixon agreed that the government should help pay for family planning services for the poor. But that does not include abortion. Under current law, federal funds can only be used to pay for abortions in cases of rape, incest or to save the mother's life.
JUNE SIMMS: People may agree that unwanted pregnancies should be avoided in the first place. But that does not mean they agree on the issue of contraception.
In recent months, birth control has become a topic of heated debate. It started last December with a government decision about a birth control product called Plan B. Plan B, often called the "morning after pill," is meant as an emergency form of contraception. It can prevent pregnancy if taken up to seventy-two hours after unprotected sex.
Woman age seventeen and older can buy it at a drug store without a prescription. Federal officials wanted to approve a request by Plan B's maker to also let girls under seventeen buy it without a prescription.
BOB DOUGHTY: But President Obama's secretary of health and human services, Kathleen Sebilius, intervened to block that approval. She said there was not enough research on the use of Plan B in younger girls.
Critics said the Obama administration was just trying to avoid what could have been a politically hot issue in the presidential campaign. They said making Plan B available without a doctor's order could help more teenagers prevent pregnancy. But supporters of the decision say younger teens who are worried about being pregnant should have to talk to an adult for guidance.
JUNE SIMMS: Another cause of the birth control debate came in January. The administration announced that all health plans provided by employers will have to pay the full cost of women's preventive services, including birth control.
Women would not have to pay any extra, like the co-payment that Elia was making for birth control pills. Elia is twenty-three. She says she wants to start a family but wants to finish her education first. But she says her daily pills were costing too much.
ELIA: "It's a burden for somebody my age to have to think about how to afford even just the co-pay of twenty dollars a month for birth control. I have a good job, but twenty dollars a month every single month ends up being quite a bit over the course of a year."
So Elia says she has stopped using the Pill and started using condoms. The cost is lower, but experts say the risk of an accidental pregnancy is higher.
David Downing is a women's health doctor at Washington Hospital Center. He says Elia's story is common.
DAVID DOWNING: "Some patients do make decisions based on their pocketbooks. And sometimes that decision doesn't necessarily go along with what the best medical recommendation is."
Dr. Downing says not having to pay for contraception would help about eighty percent of his patients. He says women would have more control over their reproductive health and there would be fewer unplanned pregnancies.
BOB DOUGHTY: But opponents say the government does not have a right to tell employers what health services they must provide to their workers. Most Americans buy health insurance through their jobs and share the cost with their employers.
In March, opponents held protests in a number of cities. A fourteen-year-old girl named Veronica took part in a demonstration outside the Health and Human Services building in Washington.
VERONICA: "It's a horrible thing that our government is forcing upon us."
The debate also has a religious connection. This involves employers such as schools or hospitals that are part of religious organizations that do not believe in birth control. They say requiring them to provide health coverage for contraception would violate their constitutional right to religious freedom.
A Catholic mother named Heather brought her five children to last month's rally in Washington. She explained how she sees the issue.
HEATHER: "What if one of my children grows up and owns a company, and they have employees that are demanding that my children pay for their abortions or their contraception? That's completely unjust and against our Constitution."
The policy would not require insurance companies to pay for abortions. Also, the administration has proposed what it considers a compromise with religious groups so that some would not have to follow the new policy.
The policy is supposed to take effect this August as part of the Obama administration's major health law, known as the Affordable Care Act. Before then, however, the Supreme Court is expected to rule on the future of the law itself.
Some people, especially critics, call it Obamacare. Congress passed it in twenty-ten. Last month the Supreme Court heard arguments about major parts of the law. These include a requirement for most Americans to have health insurance by twenty-fourteen or pay a fine.
Opponents say the Constitution does not give the government the right to require individuals to buy something. Supporters say the goal is to keep down costs for everyone and prevent people who do not have insurance from waiting until they get sick to buy it. The law bars insurers from denying coverage to people with pre-existing conditions.
The Supreme Court is expected to rule by the end of June.
JUNE SIMMS: Some Democrats accuse Republicans of leading a "war on women" by opposing measures like the new contraception policy. Mitt Romney, the leading Republican presidential candidate, told one young woman if she wanted "free stuff" from the government, she should vote for President Obama.
The majority of American voters are women. Public opinion surveys show Mr. Obama with a large lead among women in the most competitive "battleground" states. But how important an issue is birth control in the race toward Election Day in November?
In a national Gallup Poll in late March, fifty-five percent of women voters rated government policies on birth control as important. Only thirty-five percent of men agreed.
Women are more likely than men to identify themselves as Democrats. And Democrats are much more likely than independents or Republicans to say birth control policies will be important to their vote. But even Democrats rated those policies last on a list of important issues. Among all voters, the top issues were health care, unemployment, the federal budget deficit, international issues and gasoline prices.
BOB DOUGHTY: Our program was written by Kelly Nuxoll and produced by Brianna Blake. I'm Bob Doughty.
JUNE SIMMS: And I'm June Simms. Tell us what you think about these issues. Share your comments at 51voa.com, where you can also find all of our programs with transcripts, MP3s and podcasts. You also can find us on Facebook and Twitter at VOA Learning English. Join us again next week for THIS IS AMERICA in VOA Special English.