Susan BornsteinThe ability to control their fertility makes it possible for women to achieve other goals that they have for themselves and their families, whether it is finishing high school, going to college, pursuing advanced degrees, saving for their futures, or having greater freedom to travel, work long hours, or raise their children. Women who become pregnant accidentally have an increased risk of depression, domestic violence, less economic stability, lower educational attainment, and are more likely to terminate a pregnancy.
The majority of unintended pregnancies can be prevented. A pilot program in Missouri which provided long acting reversible contraception at no cost to the patient reduced the rate of teenage pregnancy by 80%, and the abortion rate was half that of the national and regional rate. In addition to preventing pregnancy, contraceptives have other desirable side effects as well. Male condoms reduce the risk of acquiring sexually transmitted diseases such as gonorrhea and chlamydia. Oral contraceptive formulations can decrease acne breakouts, help with premenstrual syndrome symptoms, and reduce or eliminate heavy periods. Contraceptive patches and the contraceptive ring work similarly to combination oral birth control pills, but may provide greater ease of use for some women. Depo-provera shots are administered every 3 months, usually in a provider’s office. Progesterone releasing intrauterine devices (IUD) have a duration of effectiveness of 3-7 years depending on the exact type. In addition to providing excellent contraception, they can decrease or eliminate menstrual flow, as well as period cramps, for many women. The copper IUD provides birth control for up to 10 years, and is a great option for women who prefer to avoid hormonal preparations, or cannot use them for medical reasons. The contraceptive implant (Nexplanon) is a progesterone-only option that is inserted just under the skin of the upper arm, and lasts for 3 years. Tubal ligation and vasectomy are very effective, although not 100%, and are considered permanent.
All of these methods significantly reduce the unintended pregnancy rate compared to both natural family planning or no birth control at all. Policies which make contraception available for little to no cost, easily accessible, and without judgement, bias, or penalty are policies which are good for women, good for their families, and good for society.
