In 1975, country legend Loretta Lynn released a song with these lyrics:

All these years I’ve stayed at home
While you had all your fun
And every year that’s gone by
Another baby’s come
There’s gonna be some changes made
Right here on nursery hill
You’ve set this chicken your last time
‘Cause now I’ve got the pill.

She was denounced in pulpits throughout the country and the song was banned from many radio stations.   It wasn’t the first time a song of hers had been banned.  A few years earlier, her hit song, Rated X, about the double standard applied to divorced women, sparked similar outrage from the usual suspects, and was also banned.  Lynn didn’t set out to make big political statements.  She simply wrote from her life experience and the raw truths she expressed resonated with her many fans.  In a 2010 interview with Terry Gross on NPR’s Fresh Air, Lynn remarked that she recorded a lot of songs that tell it like it is.  “I guess,” she mused, “we’re not to talk about the way it is.”

Lynn had her first child when she was just 14 years old, and four children by the time she was19. By the time she recorded “The Pill” she’d had six children, (including a set of twins), and three miscarriages.  She never took birth control pills, but would have, she told Terry Gross, had they been available to her. “It’s hard for a woman,” she said, “to have so many kids.”

I think of her now as I struggle to respond to the birth control issue.  I am an intensely private person, not one of those writers who regularly examine and analyze their personal lives for public consumption. But the attack on birth control and women who use it, (nearly all women, during their child-bearing years), is deeply personal.  The insults Rush Limbaugh, Patricia Heaton, and others have heaped on Sandra Fluke, hit me like blows to the stomach.  The attacks politicians make on insurance coverage of birth control for perceived political gain – (Who are the real prostitutes here?) – similarly hit me where I live.  Is there any better illustration of the maxim the personal is political?

I became a mother when I was just 19 years old.  Hospitalized as I reached my 8th month of pregnancy, (we didn’t measure it in weeks back then), doctors deliberated what to do as my symptoms – high blood pressure, protein in urine, severe edema, and other markers of pre-eclampsia – escalated.  I am small in stature – just 4’9” tall – and that combined with my naiveté and shyness gave the appearance of a younger person.  A friend who saw a photo of me back then remarked that I looked about 14 years old.  One of my nurses told me that other mothers on the floor were worried about me and had asked whether that “little girl” was going to be alright.

Within a few days, concerned about my deteriorating condition, my doctor decided to go ahead with an emergency c-section.  It was a deeply traumatic experience for me.  The first time I saw my tiny baby, he was in an incubator struggling to breathe with immature lungs.  I began to cry.  Be strong! I whispered.  I think I was talking to both of us.  So began, 35 years ago this week, one of the most profound, passionate, and ultimately enriching relationships of my life.  Happy Birthday, son!  I am a fortunate woman to have you in my life.

I am also fortunate to have lived at a time and place where safe, reliable, and humane methods of birth control are available.  (I say humane because human beings have always found ways to control the number of children in their families, through a variety of means, including risky abortifacients and infanticide.)  I can’t imagine the toll it would have taken on my health to go through as many pregnancies as Loretta Lynn did.

In 2007, pre-eclampsia and eclampsia accounted for 18% of maternal deaths in the United States (compared with 15% world-wide.)  The U.S. has a dismal record when it comes to maternal deaths generally (defined medically as death of a woman while pregnant or within 42 days of termination of the pregnancy).  In 2010, our maternal death rate was three times the US government’s Healthy People 2010 goal.  Among Native Americans, the maternal death rate was 4 times the Healthy People 2010 goal; for African American women the rate was 8 times the Healthy People goal.  Women living in low-income areas are also vulnerable.  They were twice as likely in 2010 to experience maternal death as were women in high-income areas.  “Near misses,” or pregnancy-related complications that nearly cause death, have increased 25% since 1998.

In their 2010 report, Deadly Delivery: The Maternal Health Care Crisis in the USA, Amnesty International called on President Barack Obama to address these problems, which Amnesty attributed largely to the “haphazard” approach to maternal care in this country – e.g. lack of health insurance, bureaucratic delays in Medicaid enrollment, and so on.  Insurance coverage of birth control in a country where maternal death rates are high for an industrialized country, and where  40-50% of pregnancies, (depending on geographical location), are unplanned, would seem to be an inexpensive and sensible place to start.

However, the main defense of insurance coverage for birth control in this debate that I have read is not maternal health, but rather dysmenorrhea and prevention of ovarian cancer.  Those are also good reasons to require birth control coverage.  But we can talk about women’s health issues until, to use one of my mother’s expressions, we are “blue in the face,” and it will not move the vocal – and powerful – minority  opposed to the birth control coverage mandate.  (The majority have already indicated they think contraceptive coverage is a health, rather than religious, issue.)  The reason is that they do not care about women’s health.  They are motivated instead by right-wing economic and/or religious ideology.

The economic ideologues are opposed to any government regulation of business.  The religious ideologues are opposed to sex divorced from potential childbearing.  The unholy alliance between the two was forged decades ago, when Republicans realized they could not win elections solely on platforms that benefited the rich and corporations.  It is not original or new to suggest that because right-wing economic policies are not supported by most Americans, (for example, a majority of Americans support single-payer health care) they have to cynically use social issues to gain power.  The result is that the issue of birth control coverage in our debased political culture manifests as slut-shaming.

One would think that Christians could be appealed to on humanitarian grounds; that they would care about women’s health and potential suffering.  Some of them do. The problem is that most of those aren’t speaking up.  I rolled my eyes when religion reporter Nicole Neroulias wondered in a Huffington Post article why religious journalists have not acknowledged or reported on the “myriad health issues, from ovarian cancer, menstrual problems, hormone imbalances and fertility treatments to cystic acne” for which birth control pills are commonly prescribed.  Where has she been?

Moderate Christians routinely remain silent while the extremists suck up all the political air.  It’s a reason atheist Sam Harris criticizes religious moderates.  “Because of the respect that moderates demand of faith-based talk,” he argues, we can’t “say the really critical things we must say about the abject stupidity of religious fundamentalism.”

Since it’s useless to counter these economic and religious fanatics on health grounds, we might as well take a page out of Karl Rove’s book.  By that I don’t mean unfounded smears, vicious attacks, lies, and so on.  I refer instead to his tactic of confronting opponents on their strengths rather than their weaknesses.  Recall, for example, that Rove successfully targeted John Kerry’s Vietnam-era military service, a factor that should have helped Kerry in an election against someone whose dad pulled strings to get him a slot in the National Guard.  Similarly, we need to directly confront the religious and economic ideologies behind these attacks on women.

We need to challenge their pretense that large powerful institutions like the Catholic Church are somehow persecuted and oppressed, and that the religious rights of institutions trump those of individual citizens.  We need to assert our right to religious beliefs that differ from theirs, and to every citizen’s right to freedom from religion entirely.

We need to point out forcefully and often that because we don’t have a public single-payer health insurance system, we must buy health insurance from private businesses.  If the owners of these businesses cannot respect religious differences and refrain from imposing their beliefs on their female employees, then they should either campaign for single-payer health care or give up their businesses entirely.  Clearly, they do not understand that employers do not own employees and must respect their civil rights, and are therefore unfit to run a business in a society that guarantees religious freedom.

We need to challenge religious leaders to elaborate their beliefs beyond the simple notion that sex is just for procreation.  We need press them to justify the potential consequences of proscribing birth control.  We should ask them, for example, whether they agree with Martin Luther, the founder of Protestantism, who asserted that:

If a woman grows weary and, at last, dies from childbearing, it matters not. Let her die from bearing; she is there to do it.

Or with St. Augustine who declared:

Any woman who acts in such a way that she cannot give birth to as many children as she is capable of, makes herself guilty of that many murders.

We need to ask them bluntly whether they think it’s god’s will that should women suffer, as traditional Christian writers asserted was women’s lot; whether they think ovarian cancer is just the price women should pay to ensure no one has the opportunity of sex without the risk of pregnancy.  And we should call them on the lie that birth control is cheaply and easily available elsewhere; that they just don’t think their businesses should pay for it.  If their only goal is to exempt themselves, why the attacks on Planned Parenthood?

Finally, we should stop evading the issue of sexual freedom, of sex for its own sake, rather than just for procreation.  We need to stop cowering behind ovarian cancer and debilitating menstrual symptoms as justifications for birth control usage. We need to insist instead that sexual activity is a natural and healthy human behavior.

In her 1975 song celebrating the pill, Loretta Lynn sings not only of ending her childbearing, but also of embracing her sexuality:

This old maternity dress I’ve got
Is goin’ in the garbage
The clothes I’m wearin’ from now on
Won’t take up so much yardage
Miniskirts, hot pants, and a few little fancy frills
Yeah, I’m makin’ up for all those years
Since I’ve got the pill…

Further, she sings of the pleasure she and her partner will enjoy, without the threat of pregnancy hanging over them:

The feelin’ good comes easy now
Since I’ve got the pill
It’s getting’ dark, it’s roostin’ time
Tonight’s too good to be real
Oh, but daddy don’t you worry none
‘Cause mama’s got the pill.

The Coal Miner’s daughter had the courage to speak honestly and directly about sexuality and motherhood and let the chips fall where they may.   We need to do the same if we hope to change the terms of the debate and protect women’s health and sexual freedom.