Following up on a lecture on the determinants of contraceptive use by Prof. Jenny Higgins, Pop Health 795 student Katherine Brow comments on a recent executive order from the Trump administration affecting requirements for employer health plans to pay for contraception. She writes:
During Dr. Higgins’ lecture today, I could not stop thinking about how relevant her discussion on changing attitudes regarding contraception use is to current legislation and policies being pushed by our current administration. On October 6, the Trump administration rolled back the Obama-era requirement that employer-health plans cover birth control methods at no additional cost to their women employees, on the basis that this requirement infringes on the employer’s rights to religious freedom. Although its predicted that many companies will continue to provide coverage for birth control, this new rule creates a huge loophole for any employer who doesn’t wish to provide coverage and thus many women will be forced to pay out of pocket for their prescriptions.
What I find to be the most devastating ramification of this new rule is the affirmation by our government that access to contraception and the basic tools for sexual and reproductive health is not considered to be an inalienable human right. It makes access to contraception and basic control over reproduction even more of a privilege – this policy won’t affect affluent women who can still afford insurance that covers contraception, but rather those who depend on their employer to provide coverage. The same administration is also launching attacks on organizations like Planned Parenthood that provide care to disadvantaged individuals who don’t have the insurance to cover birth control. After this new rule rolled out, the response on social media condemning this action was overwhelmingly based on the fact that many women go on birth control for a slew of reasons: including management of irregular, painful, or heavy menstruation, control of premenstrual symptoms and acne, prevention of bone thinning and anemia, among many others. These are all extremely legitimate reasons for a person to go on birth control but what stood out to me is that the majority of people didn’t talk about one of the major (if not THE major) reason women choose to go on birth control: to prevent unwanted pregnancy. Since the beginning of the reproductive rights movement, advocates have had to market the pill and other methods as being a medically relevant good in order to overcome the enormous stigma against positive female sexuality.
So, this leads me to my biggest question following Dr. Higgins’ lecture: how can we shift the overall narrative of contraception as a medical good to a sexual good when we are still fighting for the social and legal legitimacy of birth control? How can we assure the sexual acceptability of contraction for all women when it’s still a privilege simply to have access to quality birth control? As Dr. Higgins discussed in lecture, we can start this cultural shift within our own personal relationships with family members, clients, or patients, which can give a lot of hope in times where significant change seems futile. And going along with the general theme of this class; we do have evidence-based research and measures of the sexual acceptability of contraception – we just have to continue our work and empower others so that change is possible.