The Trump administration just announced its intention to rollback portions of the Obamacare mandate that requires most employers to include birth control coverage in their health insurance plans. It’s a mandate that has guaranteed 55 million women free birth control since 2010, and saved women billions of dollars on birth control pills alone.
The new interim final rules released on Friday are steeped in hypocrisy. In the same week that team Trump said it would support a 20-week abortion ban that passed the House and is now headed to the Senate, it announced a change that will only make it harder for women to determine if and when they want to become pregnant.
Which is what birth control does.
The abortion rate in the United States is the lowest it has been since Roe v. Wade passed in the 1970s, thanks in part to greater access to birth control. If the question is how to prevent abortions, contraceptive access is a major part of the answer.
But preventing pregnancy is not the only thing birth control does. Birth control, in its many forms, is health care. It’s medication that 14 percent of women turn to for strictly non-contraceptive reasons. Like...
Reducing PMS.
Reducing premenstrual dysphoric disorder (PMDD).
Regulating irregular cycles...
...And treating heavy periods.
Reducing menstrual migraines.
Managing acne.
Managing the pain of endometriosis.
Managing the symptoms of polycystic ovary syndrome (PCOS).
Lowering the risk of anaemia.
Controlling the symptoms of uterine fibroids.
Helping to prevent certain cancers.
Yet despite the many benefits of birth control, some employers seem ready to pounce on the change.
According to data released by the Center for American Progress in August, 45 entities requested exemptions to the birth control mandate between 2014 and 2016, following the Supreme Court decision that for-profit companies with certain religious and moral beliefs do not have to offer employees birth control. More than half of the companies seeking an exemption were for-profit corporations, while far fewer were non-profits or educational institutions with religious affiliations. Many indicated they were specifically seeking an exemption from providing the most expensive (and also the most effective) forms of birth control, like IUDs.
As Dr. Anne Davis, consulting medical director for Physicians for Reproductive Health, said in a statement on Friday—joining a chorus of reproductive rights advocates who are outraged by the rule: “An employer’s beliefs have no place in these private decisions, just as they would not in any other conversation about a patient’s health care.”
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You Can Get It For Free
One of the most buzzed about parts of the Affordable Care Act is the so-called contraceptive mandate, which requires that most private health insurance plans cover birth control without a co-pay or deductible. In other words, for free. There are exceptions. Certain plans have been grandfathered in, or given more time before they have to adhere to the change. Religious employers are also exempt. And while the mandate requires that the full range of FDA-approved prescription contraceptives be covered, it does not require that all brands be covered, so you might have to switch to a generic drug in order to get your contraception for free. Planned Parenthood recommends calling the member services number on the back of your insurance card to talk about what is covered by your plan.
Inconsistency Is A Big Problem
The two-thirds of women who use contraception consistently and correctly account for just 5 percent of unintended pregnancies, the Guttmacher Institute reports. On the other hand, the 19 percent of women who use birth control inconsistently account for a whopping 43 percent of all unintended pregnancies. Take the birth control pill, for example. Every year, fewer than 1 in 100 women will become pregnant if they take the pill every day, but 9 in 100 will if they don't manage to take the pill daily. Women often absorb the message that the pill is practically 100 percent effective. That's only the case if they take it precisely as directed, day-in and out.
You May Have To Monitor Side Effects
All brands of the pill are equally effective at preventing pregnancy, but that doesn't mean they're all equally well-suited to you and your body. And for a lot of women, the onus is on them to figure out what is best."Gynecologists will prescribe the pill they have the most experience with or the one they currently have free samples of in the closet," Dr. James Simon of the Women's Health Research Center in Laurel, M.D., told Women's Health. Know the basics about what your options are. There are combination pills -- which contain both the hormone estrogen and the hormone progestin -- and progestin-only options, for women who can't take estrogen. Within those categories, there are different strengths and brands, and beyond that, there are plenty of modern, long-range options that aren't pills, like the IUD or the ring. If you're having side effects that you think might be related to your birth control, try tracking them in your calendar and taking that information with you to your next appointment with your gynecologist. It'll help your doctor or nurse get a sense of what you're experiencing and guide them toward better options for you. Some side effects may go away after your body adjusts, others may not. But you shouldn't have to settle for discomfort.
IUDs Are Most Effective
A study published last spring in the venerable New England Journal of Medicine found that intrauterine devices, or IUDs, are 20 times better at preventing unintended pregnancies than the birth control pill, patch or ring. Why? Because IUDs -- which are small t-shaped devices inserted into a woman's uterus -- eliminate human error. (For more on that, check out the previous slide.) They're currently the most effective long-acting, reversible option available -- and they are safe, despite lingering belief that they aren't.
Odds Are, The Pill Didn't Cause Your Weight Gain
Early versions of the birth control pill had higher doses of hormones and caused many women to gain weight, but most modern iterations do not. Numerous studies have found no link between combination pills and subsequent weight gain, although the American Congress of Obstetricians and Gynecologists points out that progestin-only pills can cause women to put on some pounds. As Time reports, there are two reasons why the birth-control-pill-weight-gain-connection endures: Girls often go on the pill when they are teenagers and may gain weight simply because they're growing up, but think it's because of the pill. Many women also go on the pill when they're in a committed relationship, and research suggests that coupled women tend to gain weight. However, as ABC reports, women can experience bloating or stomach distention when they switch or go on or off their birth control, so absolutely speak up if that's something you're experiencing.
Other Meds Matter
There's a reason your doctor asks what other medications you're on before writing a prescription: Some drugs don't mix with others. And that absolutely holds true for your hormonal birth control. The list of do-not-combine-with-birth-control drugs includes, but is by no means limited to, certain antibiotics, anti-fungal medications, antidepressants and even some natural supplements, like St. John's wort, which can diminish the efficacy of birth control pills with estrogen.
You Can Use Birth Control Indefinitely
As the Mayo Clinic says, healthy women who don't smoke can generally safely remain on birth control pills for as long as they'd like -- through menopause even. "Years ago it was thought that prolonged use of birth control pills would interfere with a woman's subsequent ability to conceive, but this has been shown to be false," Dr. Mary M. Gallenberg, a Mayo Clinic OBGYN explains. "Similarly, doctors used to recommend taking an occasional break from birth control pills, but this offers no benefits and may increase your risk of an unplanned pregnancy." Of course, there are permanent birth control options, like sterilization, that women and their partners can also consider if they're not having children or are done having kids.
Stopping? You Can Get Pregnant Right Away
"In the past, doctors had concerns that if you conceived immediately after stopping the pill, you had a higher risk of miscarriage. However, these concerns have proved to be largely unfounded. The hormones in birth control pills don't linger in your system," according to the Mayo Clinic. "Women don’t need to get off the pill three to six months before they’re trying to conceive, their bodies return to normal right away," Dr. Katharine O’Connell White, an OBGYN with Baystate Medical Center in Springfield, Mass., told Time. The same holds true for the IUD: ACOG says women can try to get pregnant as soon as it is removed. That said, some women may experience a gap between when they stop using contraception and when they begin ovulating. If you don't get your period within several months, you may have something referred to "post-pill amenorrhea." Talk to your health care provider.
You Can Get Protection 5 Days After Unprotected Sex
There has been a lot of confusion about what emergency contraception is and is not. Drugs like Plan B offer a means for women to prevent pregnancy up to five days after a woman has unprotected sex (although with Plan B effectiveness decreases the longer women wait; ella, another brand, which is available by prescription only, remains equally effective within that five day window). They are not the abortion pill. Another option is to have an IUD inserted within five days of unprotected sex. The point is, even if you have unprotected sex, there are safe methods that can help prevent pregnancy if that's what you want.
Male Birth Control Is On the Horizon
Though researchers are loathe to put a date on when we can expect it, they say that both hormonal and non-hormonal birth control options for men are on the way, with research efforts supported by high-profile groups such as the Bill and Melinda Gates Foundation. Case in point, last summer scientists discovered a molecule that dramatically lowered sperm counts in mice and that could, one day, be used in humans.
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