Trying to keep up with the many political, policy, and research developments on contraception can be challenging these days. It was even more so on September 26, which was World Contraception Day. On the one hand, there are steps forward...
For women in the U.S. and around the world who spend years of their lives seeking to avoid pregnancy, there are now many options to help them do so. As noted in a piece posted on the Gates Foundation's website, more than 20 different methods of contraception are now available, many of which are 99-percent-plus effective.
There are also exciting initiatives such as the agreement announced by President Clinton and other world leaders to make a highly effective form of birth control available at half the existing price for 27 million women in the developing world.
On the other hand, there are steps backward...
Despite almost universal use of contraception in the U.S. and decades of bipartisan support for helping low-income women access birth control, an important new article published in the New England Journal of Medicine (NEJM) points out that political support and funding for these programs have begun to erode. There have been numerous attacks on contraception in this election season, and several states have taken actions that severely affect low-income women's ability to get birth control and other vital preventive services.
Since everything is bigger in Texas, perhaps it is fitting that the mess on these issues is bigger in Texas too. The NEJM article details the cuts to family planning services in the Lone Star state and the devastating real world effects these cuts are having on community clinics and the women they serve. Not surprisingly, the burden is falling heaviest on those who can least afford it. Researchers found that clinics are closing; those that remain open are restricting access to the most effective types of contraception because of their higher up-front costs;and that, faced with new fees, women are choosing less effective methods. As one person interviewed put it, providers are "trying to decide, out of the most vulnerable, who is the most, most vulnerable."
While there is no question that access to affordable and effective birth control is life saving and life changing in developing countries, it is also hugely important here in the U.S. Among women surveyed at family planning clinics across the country, the single most frequently cited reason for using birth control was "I can't afford to take care of a baby now." This study by the Guttmacher Institute also underscored that women use contraception in order to help achieve education, employment, and family goals.
Yet, women in Texas--and elsewhere--are having to choose between getting effective contraception and meeting other immediate economic needs. Instead of stepping backward, shouldn't we step forward on the evidence that removing cost barriers helps women choose the most effective contraceptive methods? Shouldn't we step forward on the clear evidence that contraception helps improve maternal and child health and women's educational and economic status, and reduces costs?