Birth control. We all had at least one experience with it, whether we have used it ourselves of know someone who has. I for one began taking birth control pills at the age of 18. I remember the day I got it prescribed to me, it was near Halloween and I was getting “serious” with my then-boyfriend. It’s been almost four years since, and that little pill has been one of the only things constant in my journey from a wide-eyed freshman to nervous, yet hopeful senior.

Behind sterilization, the pill is the second most popular kind of birth control, according to the Center for Disease Control. There are a lot of great reasons why women use birth control pills, such as clearer skin, fewer cramps, weight loss and lighter periods. And, of course, not getting pregnant is a positive side effect. But not every woman takes birth control as a means of contraceptive. The Family Growth Survey by the Guttmacher Institute found that 14% of the women taking birth control pills do it to prevent cramps, heavy periods and other side effects of the monthly. Understanding how the pill works, how people can access it, current politics around it and the impact they have on the country and the women who use it is an important way to understand each other and, for those who use it, ourselves.

What is Birth Control?

The pill, designed by Gregory Goodwind-Pincus and Carl Djerassi, was approved by the FDA at first as a way to regulate menstruation in 1957. It wasn’t until 1960 that the first brand, Enviod, was announced as an oral contraceptive, yet, it wasn’t until five years later that the pill became legal nationwide. According to MedlinePlus.Gov, these pills are man-made forms of the hormones estrogen and progesterone, which are naturally made in a woman’s ovaries. Other forms of birth control include IUDs, shots, patches, etc.

How to Get Birth Control

In the United States, birth control pills are only available through a prescription. When a woman begins going to the gynecologist, she can be prescribed birth control. According to Planned Parenthood, prices of birth control can vary from $0-$50. Because of the Affordable Care Act, many insurances cover all forms of birth control, including birth control pills, for free. Without insurance, Medicaid or other government programs may cover it. Planned Parenthood will also provide care whether or not someone has insurance.

I asked my pharmacist if I could simply buy a pack in an emergency (if I lost one or something like that). She priced it at $33 dollars. This is pretty cheap considering the price of a tank of gas is about the same. And one Plan B pill, otherwise known as the morning after pill or emergency contraceptive, costs more (from $40-$50). However, there are other options that are much cheaper.

Lately, subscription boxes have become popular. A popular subscription plan called the Pill Club allows users to have their doctors send a prescription and get sent birth control for free if it is covered by their insurance, or it can be priced at a $15 dollar consultation and $20 for a three month supply if they don’t have insurance. The birth control also comes with free little gifts. At about $35 with tax, that’s about the same price as a one month supply without insurance at my pharmacy. For more information about this go to ThePillclub.com.

Yet the United States still has much improvement underway as far as widening access to birth control.

Access to Birth Control in the United States

In 2013 writer Elizabeth Rosenthal wrote a news analysis for the New York Times titled “Is it Time for Off the Shelf Birth Control Pills?” In the year prior, the American College of Obstetrics and Gynecology (OBGYN) released a proposal that birth control pills should be sold over the counter without a prescription, as it was proven to be safer than pain pills like Motrin and it would increase access to these successful contraceptives, thus bringing down the rates of unintended pregnancy. According to the article, the pills are safer than ever, as they have lower doses of estrogen than in the past.

The biggest barrier to adherence is the logistics of a prescription — you run out on a Saturday night, you lose your pills, you go on vacation, you can’t get a doctor’s appointment,” Dr. Daniel Grossman, a gynecologist, told the New York Times.

I myself have been in this situation. When I took a trip to Canada with my family when I was 18 and made a stop to sleep in a hotel overnight on the way up. I went to go take my pill…. and I realized that I forgot it. I was panicked, knowing that missing pills can cause negative side effects. I was frantic, as I made calls to my pharmacist, my insurance company, my doctor… I even had to have my dad step in because I didn’t even know how to talk to an insurance company, which was very embarrassing for 18 year old me. Finally, I was able to get it in Buffalo just before we were going to enter Canada. The best part is, next time I went to go pick up my birth control the next month at my hometown in Suffolk County, they sent it to Buffalo again….and again… and again. They sent it to Buffalo for a whole year, making me have to call every time before I picked it up so that they could refill it. So yes, I see that there is a need for over the counter pills.

According to this article, there are countries that have over-the-counter birth control pills by having a pharmacist screen a woman for any possible issues. The article also argues that costs associated with birth control, such as the yearly doctor appointment a woman must attend to get birth control renewed could add up in copays, depending on a person’s insurance. On the other hand, checking blood pressure is a way to make sure a woman is safe on the pill and gynecologists argue that many women need counsel to prevent the spread of STDs and STIs and to promote correct use.

Years later, however, nothing has really changed… except for some of the politics.

Birth Control Gets Political

On Jan.14, a federal court issued a nationwide ruling decided by Judge Wendy Beetlestone of the Federal District Court of Philadelphia that would block the Trump administration’s attempt to interfere with birth control access guaranteed under the Affordable Care Act. Beetlestone wrote that repealing this access would force at least 70,500 women to lose access to birth control.  

Judge Beetlestone issued her ruling 24 hours after Judge Haywood S. Gilliam Jr. from the Federal Court in Oakland California blocked the rules from 13 states and D.C.

This was not the first time Trump lost in his effort to allow employers to deny birth control coverage based on their religious and moral principles even though, under Obama, religious houses of worship were already exempted from the mandate that all employers must provide birth control, along with religious hospitals and universities, which could seek accommodations from the mandate. The case Burwell v. Hobby Lobby in 2014 decided that even “closely held” private businesses could seek accommodations as well, and these accommodations would allow employees to get birth control directly from their insurance instead of the business.

Health and Human Services under the Trump administration released interim rules in 2017 that would allow businesses to drop birth control coverage for religious and non-religious moral principles, and this time the employee would not be able to get that birth control directly from their insurance. According to Health and Human Services, these rules would leave in place government programs that provide free or subsidized contraception for low-income women through community centers, and they predict that the exemptions should affect no more than 200 employers. The final sets of rules were expected to take effect in January. According to an article from Vox by Anna North, the rules do not require employers to file any paperwork. All they would have to do is notify their insurance company.

Personally, I do not believe that certain people, including nuns or rabbis, should have to cover birth control. Yet, these are the situations that should be covered on a case-by-case basis. Just because nuns do not have to cover birth control, does not mean that a man who “believes” that birth control causes miscarriages shouldn’t have to. Speaking of that unproven, yet widely held belief, some authors of the rules actually hold those convictions. Matthew Bowman, an HHS lawyer who helped write the rules wrote a column in 2011 for the conservative website, Townhall, called “HHS’s abortifacient/ sterilization mandate violates religious freedom.” In this column, he argued, citing a memo released by the Alliance Defense Fund, an institution he is a part of, that the birth control mandate under the Affordable Care Act violated the rights of Christians and those who are Pro-Life. Bowman wrote that “In the category of ‘FDA approved contraceptives’ included in this mandate are several drugs or devices that cause the demise of an already conceived but not yet implanted human embryo, such as certain intrauterine devices (IUDs). Likewise in that category are many birth control methods that potentially prevent embryos from implantation, such as ‘the Pill’ and ‘emergency contraception.’” The quote speaks for itself. If you were really pro-life, wouldn’t you be for people using contraception rather than getting abortions?

A White House domestic policy aide who reportedly worked on the rules, Katy Talento, spent years spreading misinformation that she believed was true about birth control.

Multiple times in the conservative magazine, The Federalist, Talento called birth control carcinogens, despite birth control usually lowering the risk of cancer. She also called birth control uterus ruining, causing miscarriages.  

Hostility towards birth control didn’t even start with the Trump Administration. According to the American Civil Liberties Union, it does not violate a woman’s constitutional rights for a pharmacist to deny birth control at a privately or even state-owned pharmacy. However, a state’s pharmacy board does, for the most part, expect all pharmacists to conduct themselves professionally and decide what’s best for their patients.

No matter where you stand politically and morally, there is no denying the impact birth control has on the country. It’s important that people who write rules that directly affect a woman’s body base them on facts, rather than their personal beliefs. I do believe that people with certain religious convictions should not have to cover birth control as long as they can prove their convictions and state why providing contraception coverage would threaten that. However, these issues were already addressed with the Affordable Care Act. Some of the writers of these rules clearly had problems with birth control in the first place, so it’s suspicious as to why this administration would want to make it easier to not cover birth control. Hmm….

Impact of Birth Control

Since 2008, rates of unintended pregnancies have dropped.

According to a Guttmacher report, family planning services helped prevent two million unintended pregnancies, which could have resulted in one million unintended births and about 700,000 abortions in 2014.

And not all women take birth control to prevent unwanted pregnancies. Having access to birth control is just as important for these women as well, as 40% of women report having their period pain affects their ability to work, according to a YouGov survey. YouGov also found that 82% of women do not receive accommodations for period pains from their workplace. Women also use birth control for medical issues such as ovarian cysts.

Contraceptives also help women time, space and number their births, helping prevent the likelihood of premature and underweight births.

And finally, birth control helps empower women. According to the U.S. Census Bureau, the number of women in the workforce has tripled since 1965 and for married women’s labor force participation has almost doubled.  Of course, laws and social movements are behind these positive changes, but allowing all women, including married women, to decide when they want to or if they want to have children with just a little pill is empowering and revolutionary.

Now, I am a firm believer that everyone is entitled to their opinion, but when debating access to birth control remember these things:

  1. Since birth control pills are not available over-the-counter, not covering the pill would not only add up in the monthly tab, whether it be through a pharmacy or a subscription plan, it would add up in doctor appointment costs since women must go once a year to renew their prescription.
  2. Birth control curtails the annual cost of unexpected pregnancies.
  3. Birth control reduces the rates of abortion and accidental pregnancies.
  4. Women take birth control for many reasons outside of pregnancy prevention.
  5. If your argument is religious remember that married women use birth control too. And unlike many claims, they do not cause miscarriages.
  6. Allowing women to choose when and if they want to have a baby is powerful.
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