The Importance of Accessibility to Contraception

Emma Poitras

As medicine has progressed, the variety of options of contraception have become

incredibly vast, there is no shortage to different kinds of contraception, and there is an option for
most lifestyles, bodies, and individual needs. That being said, the issue of contraception is not
the variety, or whether there is enough, but rather the accessibility of it. There are a variety of
reasons that accessibility to contraception may be difficult, some being income, insurance or
healthcare, medical provider laws, or location. There are many reasons that contraception is
important, and why having access to it is just as important. Making it more available despite
income or insurance is an issue that our current healthcare system is going to have to work
towards solving or at least improving for the health and well-being of our nation’s women.

A woman's ability to access contraception at any stage in her life is important for a
variety of reasons, contraception is not limited to being used as protection against pregnancy, as
it can be used as a treatment for a variety of health complications as well. Having easy access to
contraception in order to help prevent unwanted pregnancies and to aid in helping other
underlying health problems should be a right to every female despite age, money, or location.
With lack of accessibility comes a wide range of risks, unwanted pregnancy may be one of the
top issues that come with lack of accessibility. The choice to be able to prevent unwanted
pregnancies will ultimately save the government, taxpayers, the mother, and the child's family
more money and emotional effort that it would cost to receive contraception. Having a baby
requires timing, a young girl wanting to continue her education without the responsibility of a
child would be best prepared and protected by using contraception. Some people aren’t prepared
to have a child or don’t find themselves fit, if a couple struggles to keep themselves afloat
financially then an extra person in a household would put both the parents and child at risk.
There are endless ways that contraception would prove useful to women and family wanting to
prevent a pregnancy.
 Most health clinics provide services to women which include well women checks, in
these checks, there are often PAP smears, mammograms, and breast checks. Services such as
these help provide necessary and regular health checkups to a variety of women. It is also
beneficial by keeping necessary treatments available to women of a lower income. This helps
keep communities healthy and decreases the likelihood of women developing cervical or breast
cancer by keeping checks regular and treatment available.
Often, many STIs go on without symptoms, therefore making them harder to catch or
diagnosed without appropriate testing. All clinics will do STI testing, and in some, it can be free
depending on the individual. Without available resources to receive testing for STIs the risk of
them spreading without knowing increases drastically.
Access to education is incredibly important because it can help prevent many issues
altogether, the combination of contraception and education would drastically cut down on the
number of unplanned pregnancies, education on taking precautions would further prevent STIs,
and being aware of the importance of regular check-ups once a woman reaches a certain age
would help prevent cancers and other health complications. Being aware of risks, contraceptive
options, and other health-related resources would aid in decreasing unplanned pregnancies, STIs,
and other illnesses drastically.

Many things influence women’s accessibility to appropriate care and resources, some
being location, money, and government funding/insurance. Depending on where a woman may
live in the U.S. she could have incredible access to contraception and have a variety of places to
choose from, or she may live in a very rural and conservative place that makes getting access to
contraception a challenge by limiting clinics and other important resources. In an instance where
a pharmacy or clinic is hours away from someone who lives in an extremely rural environment,
it would make picking up contraception on a regular basis or going to a clinic challenging and
unrealistic for many.
Some insurance providers will cover contraception, but others may not, or a patient's
deductible or copay is too high. Depending on the type of contraception it can be extremely
expensive and therefore hard to access, an IUD without insurance can cost up to $1,000, and
birth control pills can cost hundreds of dollars on a monthly basis. Insurance and other related
things are extremely complicated and are different for every person. Ideally, every person has a
low enough deductible or copay so that they don’t have to worry about extreme medical
expenses coming from out of pocket. Many companies or employers will provide health
care/insurance to their employees, contraception is often covered for many female employees.
This is an extremely effective way to cover a large amount of women’s contraception, therefore
increasing overall contraceptive use.
Insurance providers such as Medicaid are great for lower-income patients and will often
cover all forms of contraception. Medicaid was expanded in many states to cover an individual's
medical costs if they are below the federal poverty line. “If your household income is below
133% of the federal poverty level, you qualify. (Because of the way this is calculated, it turns out
to be 138% of the federal poverty level. A few states use a different income limit.)” 1 While this
expansion is beneficial to many, it makes it hard for people that aren't below the 133%, yet are
unable to afford other types of private insurance. This middle ground makes it difficult to get
affordable access to forms of contraception as well as other healthcare options.

There are excellent resources available in order to provide access to contraception, some
being local health providers such as an individual's regular doctors office, or places such as
Planned Parenthood. Planned Parenthood is vital to communities because it provides resources
such as contraception in a way that it is available to everyone despite income or age. Often,
finances make a big difference in choosing whether or not contraception is something that is
realistic for a female. At Planned Parenthood they try their hardest to make contraception an
option for everyone by making it as affordable as possible. They are also a great resource for
people that may not be allowed contraception because of family members or other social
situations. They are able to make access fully confidential and as accessible as possible to a wide
range of people. Unfortunately, with the current political climate part of the government no
longer wants to fund Planned Parenthood. A long-term spending bill is trying to cut federal
funding to Planned Parenthood. Along with the cut of federal funding, they are proposing to

1
“How Medicaid Health Care Expansion Affects You.” ​HealthCare.gov​,
www.healthcare.gov/medicaid-chip/medicaid-expansion-and-you/.
block Medicaid as well as other federal funding sources altogether, meaning no federal dollars
would be going to PP. Fortunately, in order to pass a bill such as the one proposed, it isn’t fully
up to the GOP, a spending bill requires 60 votes in the Senate. While there are 51 Republicans in
the Senate, it would still require the 9 Democrats to vote in favor as well, which is extremely
unlikely. That being said, the likelihood that all federal dollars being cut off to Planned
Parenthood is minimal.
The Title X Family Planning Program has also been huge in providing general women’s
health resources at an affordable rate, this has been geared towards low-income individuals and
has made a huge difference in the world of low-income health-care. Title X itself funds
organizations that provide the actual health care, such as Planned Parenthood. According to the
Planned Parenthood website, “78% of Title X patients have incomes below 150% of the federal
poverty level.” 2 With data backing the fact that many people visiting clinics such as Planned
Parenthood are low-income and in need of a cost-effective health provider, it shows how crucial
these programs are to everyone. Ultimately, programs such as Title X save the government and
citizens money, contrary to common belief, “For every dollar invested in publicly funded family
planning programs like Title X, the government saves $7.09 in Medicaid-related costs.
Additionally, as an example, in 2010 state and federal governments saved $13.6 Billion from
publicly funded family planning programs, including $7 Billion from the Title X-funded centers
alone.” 3 Programs like Title X are useful and necessary to the public and government alike, and
also benefit patients and people in need of aid financially.

Some hospitals are religiously affiliated, in Durango, the hospital is Catholic. This means
a couple of things, in the late 19th and early 20th centuries the church and the nuns created the
hospital to provide access to low income and less economically stable communities and
individuals. Over time, this has changed, hospitals now range from Catholic to non-religiously
affiliated. Depending on the hospital, treatment can vary differently than it would in a
non-religiously affiliated hospital. Typically, a hospital being Catholic will certainly limit access

2
​Parenthood, Planned. “Title X: America's Family Planning Program.” Planned Parenthood Action Fund, National -
PPACTION, www.plannedparenthoodaction.org/issues/health-care-equity/title-x.
3
​Parenthood, Planned. “Title X: Affordable Birth Control and Reproductive Health Care.”​Planned Parenthood
Action Fund​, National - PPACTION, www.plannedparenthoodaction.org/issues/health-care-equity/title-x.
to certain practices, especially ones that tend to focus on reproductive health. Some of the things
that were found to be limited in a variety of hospitals include, “Postpartum and direct
sterilization, elimination of an ectopic pregnancy, medical assistance with a miscarriage or other
perinatal loss, screening for fatal fetal anomalies, and artificial reproductive technologies
involving donor gametes.” 4 That isn’t to say that every Catholic hospital has these restrictions,
they are just more common than they would be at a non-religious affiliated hospital. This can
limit access to contraception as well as other procedures such as abortion. Some hospitals will
not administer either of these things, making it so that even if a community has access to good
health care, they don’t have full access to other necessary procedures. Many hospitals have
benefits for their employees, including insurance coverage. Unfortunately, many of the Catholic
hospitals will not allow for contraception coverage of their employees.

Although it would be expected that most contraception options would be covered by a

women’s insurance, it is incredibly circumstantial. Typically, employers must have insurance
that will cover an employee as well as their contraception of choice. The Affordable Care Act
was created by the Obama administration with the intention to help, “Expand coverage, hold
insurance companies accountable, lower health care costs, guarantee more choice, and enhance
the quality of care for all Americans.” 5 Yet, as of recently a new set of rules have been put in
place, President Trump has communicated with The Department of Health and Human Services
and together they have created a new set of rules, in that set of rules it is stated that employers
that have ​certain religious or moral beliefs are exempt from the contraception coverage rule that
was set in place by the Affordable Care Act. According to the New York Times, “More than 55
million women have access to birth control without co-payments because of the contraceptive
coverage mandate, according to a study commissioned by the Obama administration. Under the
new regulations, hundreds of thousands of women could lose those benefits.” 6

4
Freedman, Lori. “Dispelling Six Myths About Catholic Hospital Care in the United States.”​Rewire.News​,
Rewire.News, 24 June 2014,
rewire.news/article/2014/06/24/dispelling-six-myths-catholic-hospital-care-united-states/.
5
“Affordable Care Act.” ​Medicaid.gov​, www.medicaid.gov/affordable-care-act/index.html.
6
​Pear, Robert, et al. “Trump Administration Rolls Back Birth Control Mandate.” ​The New York Times​, The New
York Times, 6 Oct. 2017, www.nytimes.com/2017/10/06/us/politics/trump-contraception-birth-control.html.
 The Affordable Care Act was put in place to cover all sorts of health issues, including
diseases, other illnesses, and cancers. The new laws put in place regarding contraception
coverage and religious preferences of employers have been problematic and affect many women
across the country. Fortunately, the new rules set in place has little effect on treatment or
prescriptions that are not associated with contraception.
There has been a constant debate on the concept of contraception over many years, and
its controversy will probably never change. Decisions about contraception as well as other things
such as abortion or access to education remain to be controlled men. With our country's political
climate, leadership, traditions, and bias, female-centered decisions are not in the hands of
women. The big problem with our healthcare and insurance system is that there are no female
voices being heard, and that just comes down to tradition and how our country has remained for
decades. Things such as contraception are viewed as a luxury or as something that is
unnecessary, despite the ways it has been proven to be effective and necessary to our nation's
women and their health. Most often, the cross between contraception and religion is where things
become problematic. The standpoint that sex is merely for the purpose of reproduction is both
outdated and completely untrue. There are many people that are in a stage of life where a child is
unrealistic, dangerous, or unmanageable, and that is ok. Having the ability to manage your body
and when/if you become pregnant should be a right to all women. The argument of why women
should not have easy to access to contraception is backed by the idea that contraception is
unnatural, and preventing a natural thing is wrong and against an individual's moral code.
Without the use of contraception, the amount of unplanned and unwanted pregnancies would
spike. Access to abortions are slowly decreasing and with the current political climate many
people want to make it so that they are fully unavailable, this would force women to carry the
babies to term or take less safe and sterile options in her pregnancy. It is in circumstances like
these that children end up in a home or situation that is unfit for them and their wellbeing. If
choices that concern a women, her body, and her child are regularly being managed by someone
that isn’t her it shows the many ways that our country needs to shift its view on women’s health
care.
 A lot goes into the concept of contraception, something that seems simple and fairly
normalized in our society has a lot of hidden working parts. The current political climate is
working against providing accessibility to all women, and other procedures that may be
necessary to some are often difficult to access due to controversy or laws. Fortunately, many
people understand how important it is that contraception and education stay available to all
women, and hopefully the bad stigma associated with sex and contraception will fade. The
concept of insurance and healthcare remains complicated, and while there are resources available
to some to help cover the extremely expensive forms of birth control, some people do not qualify
or have access to many options. Preventing unwanted pregnancies and helping maternal
concerned health issues are just a couple of the things that are beneficial that come with access to
contraception. The current political climate works against useful clinics and funding programs
that have been proven to be useful in decreasing the amount of STIs, unwanted pregnancies, and
other sexual and maternal health-centered topics. While it is unlikely that programs such as
Planned Parenthood or Title X will be fully defunded thanks to the presence of Democrats in the
Senate, people are still working to make them less accessible. Access to contraception at a
workplace with a religious employer threatens employees access. A female's right to have access
to necessary resources continues to be threatened and changed by men and other opposing
forces. By trying to make contraception more accessible to everyone (meaning keeping clinics
open, providing education, and keeping it at an affordable cost), unwanted pregnancies will
decrease and the woman's health will get the appropriate attention needed. Keeping
contraception accessible will continue to benefit all women, factors such as one’s religious
preference should not influence whether or not a woman receives contraception or other
appropriate types of care. Continuing to educate our country on contraception, maternal health,
and sexual health is a step towards creating a more progressive, safe, and accepting environment
for our women. Our country needs contraception, and there is no way of making it fully effective
without making it entirely accessible to the vast variety of women despite their location, age, or
economic status.