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Birth control: partisan or personal?

Birth control and the government

On Feb. 23, U.S. Rep. Mia Love, Republican announced that she is sponsoring a bill which would make oral contraceptives available over-the-counter, without a prescription. She sponsored a similar bill last year which didn't make it out of committee.

Former New Hampshire Republican senator Kelly Ayotte sponsored a similar bill in 2016. Last year, Senate Bill 135, legislation to make birth control pills over-the-counter passed with a unanimous vote, according to The Denver Post. SB135 was also proposed by a Republican senator, Cory Gardner.

 

The purpose of this legislation is to make birth control less expensive and readily available to women, but more readily available birth control can come with a different price.

Republican and political science major Sarah Curry thinks over-the-counter birth control is a great idea.

"I think that over-the-counter birth control is honestly the way to go," Curry said, "If it's seven bucks a month for your birth control, you can work an hour minimum wage flipping burgers at McDonald's to pay for your birth control."

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Curry uses Skyla, a three year intrauterine device. She had the device inserted before getting married in 2015. Curry knew she didn't want children right away and said her husband Alex supported her choice of getting an IUD. Under the Affordable Care Act, her insurance covered the $800 of the IUD as well as her consultation appointment, insertion and follow-up appointment. Curry paid a $60 co-pay.

The Affordable Care Act makes all different kinds of birth control affordable for all women. This particularly benefits low-income women. If the ACA is repealed, it could have a harsh effect on low-income women, especially those without insurance.

"I think that's the kind of solution that we should be working towards now, especially if the ACA is going to be repealing access to birth control for some of these low-income women," Curry said.

On a federal level, President Donald Trump has promised to repeal the ACA and is working on his own healthcare legislation. 

 

Perhaps in response to his promise, Sen. Kristen Gillibrand, D-NY, proposed an amendment that would preserve elements of the ACA dealing with women's health, including affordable birth control. The amendment was voted down in the Republican majority Senate. 

Sarah Curry sits in her apartment as she explains her thoughts on birth control policy. Like many low-income college students, she benefits from the Affordable Care Act.

A good idea that could be deadly

While making at least one standardized form of birth control sounds reasonable, making the Pill readily available can result in the death women who have adverse effects to hormones and take hormonal birth control without consulting a doctor.

Bioinformatics major Megan McGhie is one such woman. She has a hereditary condition that puts her at risk for life-threatening seizures, were she to use hormonal birth control. She became aware of her condition after one of her sisters consulted a doctor about birth control. 

Women like McGhie are a major concern for nurse practitioner Carol Graff, who has worked in gynecology for the past six years. She has patients ranging in age from 13-90. Before she became a nurse practitioner she worked as a registered nurse for 23 years.

"Birth control I feel is very important," Graff said, "I think it's important that women are able to use birth control if they don't want to have children at this time, also I think it's important for them to help control miserable periods and irregular periods or painful periods."

Graff is delighted with the major steps that have been made in the quality and variety of birth control options, and she thinks the ability to afford IUDs is important.

"I have a lot of women that we use IUDs just for period control, so they're not bleeding heavily or having terrible cramping," Graff said.

Graff is concerned about the future of affordable birth control, especially in regards to her patients. 

"I like the fact that people can get (IUDs) a lot cheaper, and insurances are covering it," Graff explained, "that has really helped my practice and my patients that way, it gives them more options."

Graff thinks making birth control pills available without a prescription is a bad idea. 

"Anybody that comes into my office, I screen them to see if they are healthy enough to be on birth control pills because estrogen does pose a risk," Graff said.

Women at risk, according to Graff, include women who are prone to migraines, smokers, women who are overweight and women like McGhie, who have a hereditary condition. Life-threatening side effects include blood clots, strokes and seizures. Graff goes through a detailed screening of patients before prescribing any sort of birth control.

If the Affordable Care Act is repealed and IUDs become less affordable, Graff is concerned for her patients who cannot take hormonal oral contraception because of health or other reasons. 

 

"If you take away the Affordable Care Act, we just jeopardize a lot of women who don't have access to insurance or who aren't covered and they can't get an IUD," Graff said.

Graff's patients include students, single mothers, and families who can't afford to have another child. All of these people benefit from the ACA.

As to whether or not the federal government should be involved, Graff isn't sure where to draw the line. She admits that certain aspects of the ACA are perhaps less than desirable, but she hopes that birth control affordability carries over into whatever  legislation the new administration creates.

"I just know that my job, having a wider variety has helped so many women who couldn't be on just birth control pills," Graff said, "I've given them better options and that feels nice."

Megan McGhie discusses her decision to have a non-hormonal IUD inserted. She had the procedure before meeting her now fiancé George Major.

Is the government responsible?

Whether or not the federal government is responsible to make birth control affordable has been an unanswered question since birth control became available in the mid-1900s.

The pendulum of responsibility has swung between President Dwight Eisenhower, who said that birth control is not the responsibility of the government and "not (the government's) business," all the way to the Affordable Care Act of 2010 which gives free access to at least one type of birth control to all women. 

The Republican platform wrote that the ACA "weighs like the dead hand of the past upon American medicine" and explains various reasons why the act should be repealed, first and foremost because it allegedly "driven up costs for all consumers." The platform does not directly address birth control, except to say it believes the FDA's "endorsement of over-the-counter sales of powerful contraceptives without a physician's recommendation" is a threat to women's health. 

In contrast to the official party stance, the only legislators to propose making birth control pills available without a prescription are Republican. 

The Democratic platform makes it's stance on brith control clear. It states, "every woman should have access to quality reproductive health care services," and that the party will defend the ACA, "which extends affordable preventive health care to women, including no-cost contraception..."

The future of affordable birth control is unclear at this time.

Different Types of Birth Control
Information provided by the BYU Student Health Center.
Consult with a doctor about which birth control is right for you.
HORMONAL CONTRACEPTION
Pills
  • Estrogen and Progesterone
  • Taken by mouth
  • Packages normally come in 28 pills. The last seven pills have no hormones, to allow for menstruation.
  • Does not interfere with intercourse
  • Must take pill within three hours of the same time every day
  • 92-99.7% effectiveness
  • $15-281.28 per month
Nuva Ring
  • Estrogen and Progestin
  • Soft plastic ring inserted into the vagina and left there for three weeks. It is then removed and nothing is used for a week. New ring inserted at the end of week four.
  • Does not interfere with intercourse.
  • In rare cases, it can fall out.
  • 92-99.7% effective
  • $103.66 per month
Patch
  • Estrogen and progestin
  • Patch applied to the skin once a week for three weeks and removed on week four.
  • Does not interfere with interourse.
  • Can cause skin irritation; increased dose of estrogen.
  • 92-99.7% effective
  • $122 per month
Depo-Provera
  • Progesterone only
  • Shot given once every three months
  • Does not interfere with intercourse
  • May stop menstruation
  • Can cause breakthrough bleeding for up to three months
  • Can cause weight gain
  • Can cause a delay in getting pregnant after stopping the shot
  • 97-99.7% effective
  • $70.61 plus $25.00 injection fee every three months
Mini pill
  • Progestin only
  • Pills taken by mouth. All pills in the package contain hormones.
  • Does not interfere with intercourse
  • May stop menstruation
  • Must be taken within three hours of the same time every day.
  • First 1-3 months may have breakthrough bleeding.
  • 92-99.7% effective
  • $18 per month
Nexplanon
  • Progestin only
  • Rod implanted under the skin on the inside of the upper arm
  • Lasts for three years
  • Does not interfere with intercourse
  • Can cause breakthrough bleeding
  • Minor invasive procedure
  • Requires procedure for removal
  • 99.95% effective
  • $825.53 plus $221.44 insertion fee
Intrauterine Device - Mirena, Skyla & Kyleena
  • Progesterone only
  • Thickens cervical mucus and inhibits implantation
  • Lasts 3-6 years
  • Does not interfere with intercourse
  • Minor invasive procedure
  • Initially can cause heavier bleeding and slightly more painful periods
  • 99-99.9% effective
  • $696-$860 plus $205 insertion fee
NON-HORMONAL CONTRACEPTION
Intrauterine Device - Paraguard
  • Small T-shaped device inserted into the uterus
  • Non-hormonal type is wrapped with copper wire, inhibiting sperm mobility.
  • Last ten years
  • Does not interfere with intercourse
  • Minor invasive procedure
  • Initially can cause heavier bleeding and slightly more painful periods
  • 99-99.9% effective
  • $806 plus $205 insertion fee
Condoms
  • Latex or vinyl sheath used by the man
  • Available without a prescription
  • Interferes with intercourse
  • One time use
  • Can be uncomfortable
  • 86-97% effective
  • Inexpensive
Natural Family Planning
  • Requires tracking basal body temperature and/or cervical mucus to predict the most fertile time of the month
  • Requires a thermometer and a graph
  • Requires accurate record keeping
  • Requires abstinence or another method of contraception during fertile times to prevent pregnancy
  • 78-(91-99)% effective 
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