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Letter to the Editor: Maurice Middleberg Defends Contraception as Preventive Medicine

Maurice Middleberg, IntraHealth's vice president of global policy, responded to Charles Krauthammer's Washington Post editorial, "Obamacare: The reckoning" in a letter to the editor, published in the Washington Post on March 26, and reproduced here. 

Charles Krauthammer questioned the classification of contraception as preventive medicine, stating that “categorizing pregnancy as a disease equivalent is a value decision disguised as science.” His characterization is incorrect.

All pregnancies carry risk; that’s why there are obstetricians. Some women are at particular risk of pregnancy complications, such as diabetes and hypertension. Unintended pregnancies can produce unintended risks. Contraception reduces the risk of maternal death and illness by enabling women to have only desired pregnancies and avoid high-risk pregnancies. Contraceptives also have non-contraceptive health benefits, including reduced risk of ovarian cancer, endometrial cancer and ovarian cysts. Further, contraception has an important impact on infant mortality, because the timing of births matters to infant survival. 

Following the Institute of Medicine’s recommendation to categorize contraception as preventive creates more choice by empowering women—not politicians, employers or pundits—to make decisions about the use of contraception.