One hundred years since birth control pioneer Margaret Sanger started working in the ghettos of New York as a public health nurse, helping families to learn how to avoid unintended pregnancies, an independent panel of doctors and health experts have recommended the availability of birth control prescriptions without co-pays. This action comes as part of the mandated reviews of certain health systems to be modified under the proposed federal health care plan.

The panel was responding to statistics from the government and a variety of other sources which have consistently shown that more than half of US pregnancies are unplanned. Reasonable people will also see this recommendation as a way to avoid abortions and the philosophical impasse the mere mention of that word generates.

But not everyone will be that reasonable, and Americans can fully expect that this latest recommendation to make birth control available to all who need it will be hotly contested by the same uninformed fanatics screaming for less government, lower taxes, and private health care.

Reality for too many Americans, especially in these tough economic times, is that an unintended pregnancy is not a joyous event but a life sentence to have, nurture, raise and support one more child the parents cannot afford to have. The time-worn response to such a statement, that the woman (but never the man who impregnates her) should have thought of this before having sex, shows total disregard for the human condition and for elements of reality that effect it: passion, spontaneity, ignorance and even poverty.

When Americans talk about the health care crisis and the cost of prescription drugs and medical equipment, they usually cite dramatic choices some elders make. We are reminded of old people having to either skip a prescription or skip food. But there are also young women having to choose between a prescription and food, and those prescriptions often are for birth control they cannot afford.

Finally, if the right is as truly concerned about eliminating abortions, it is going to have to concede that the best place to start is with reducing the risk of pregnancy occurring in the first place. Extremist positions that contraceptives that have an impact on the implantation of the fertilized egg to the wall of the uterus are “abortifacients,” or that life begins when the couple gets naked only reinforce the notion that every intercourse must result in pregnancy.

Let’s hope that reason prevails or, at the very least, that reasonable people can prevail over unreasonable ones as a governing majority. It’s time extremists were confronted with the notion that they cannot logically have it both ways. The avoidance of abortion depends on the avoidance of unintended pregnancies and that again depends on the use of any method—from abstinence to artificial methods of contraception to voluntary sterilization—that the woman and her partner may choose.

The truly “smaller” government right wingers say they prefer can get significantly smaller overnight if it will just stay out of citizens’ bedrooms—gay, straight, or using birth control.