Why women de­serve cov­er­age for birth con­trol

Look at all of the health ben­e­fits. This shouldn’t even be con­tro­ver­sial.


Although health care re­form through the Af­ford­able Care Act has not been per­fect, it did bring about many ben­e­fi­cial changes for women’s health. One was the con­tra­cep­tive cov­er­age man­date, re­quir­ing that health in­sur­ers and em­ploy­ers pro­vid­ing em­ployee health in­sur­ance cover costs for birth con­trol as they would other pre­ven­tive health med­i­ca­tions. This has af­forded tremen­dous gains for women in their in­ti­mate per­sonal re­la­tion­ships, fam­ily lives and ca­reers.

As an OB-GYN, I have seen the pos­i­tive ef­fects of the con­tra­cep­tive man­date for


pa­tients. I know many women whose lives would be dra­mat­i­cally and neg­a­tively al­tered with­out it. Un­for­tu­nately, the Trump ad­min­is­tra­tion wants to ef­fec­tively strip this away by al­low­ing any in­sur­ance provider or em­ployer to ap­ply for ex­emp­tion from this man­date for any moral ob­jec­tion.

Con­tra­cep­tion should not be a con­tro­ver­sial is­sue sub­ject to the whims of “moral ob­jec­tion.” It is a key com­po­nent of women’s health care. Not only can it al­low women to plan if and when they will have chil­dren, which is im­por­tant for healthy preg­nan­cies, but var­i­ous forms of birth con­trol have ad­di­tional pos­i­tive med­i­cal ef­fects. While con­doms are read­ily avail­able and should cer­tainly be used for preven­tion of sex­u­ally trans­mit­ted in­fec­tions, they are one of the least ef­fec­tive meth­ods of preg­nancy preven­tion and do not carry th­ese life-chang­ing ben­e­fits.

In­creas­ing ob­sta­cles for women in ac­cess­ing the range of con­tra­cep­tive meth­ods avail­able in­creases the un­in­tended preg­nancy rate. Un­in­tended preg­nan­cies cost the govern­ment bil­lions of dol­lars an­nu­ally and place women and their ba­bies at in­creased risk of ad­verse out­comes. Higher rates of un­in­tended preg­nancy also cor­re­late with higher rates of abor­tion, a med­i­cal de­ci­sion this ad­min­is­tra­tion has made clear it adamantly op­poses.

Ac­cord­ing to the Guttmacher In­sti­tute, the un­in­tended preg­nancy rate in the U.S. is at a 30-year low, and the abor­tion rate is the low­est it has been since the de­ci­sion in Roe vs. Wade. Th­ese pos­i­tive find­ings are likely re­lated to in­creased ac­cess to con­tra­cep­tives as a re­sult of the ACA, par­tic­u­larly the most ef­fi­ca­cious meth­ods that are oth­er­wise not eas­ily ac­ces­si­ble due to high up­front costs.

While some­times ideal and mag­i­cal, preg­nancy also places women at risks of sig­nif­i­cant com­pli­ca­tions within nearly ev­ery body sys­tem. It can re­sult in death, and the U.S. is the only de­vel­oped na­tion with a ris­ing rate of ma­ter­nal mor­tal­ity. Th­ese risks are par­tic­u­larly high for women who have health problems that are not ad­e­quately con­trolled at the on­set of preg­nancy. The abil­ity to time preg­nancy is cru­cial for th­ese and all women.

Dif­fi­culty ob­tain­ing con­tra­cep­tion also in­creases risks to women us­ing th­ese med­i­ca­tions for pur­poses other than birth con­trol. Women may lose qual­ity of life as well as work pro­duc­tion due to in­abil­ity to con­trol pain as­so­ci­ated with con­di­tions such as en­dometrio­sis and fi­broids. Heavy bleed­ing can lead to lifethreat­en­ing ane­mia if not sup­pressed. Ovar­ian

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