Birth Control

Access to birth control and other preventive care ensures that women can control their futures.

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Birth Control Benefit (ACA)

Thanks to the Affordable Care Act (ACA), for the first time ever millions of women now have access to all FDA approved prescription birth control coverage, with no out-of-pocket expenses such as deductibles and co-pays.  The ACA’s mandatory birth control benefit empowers more women to make one of the most important economic decisions possible: whether and when to have children. Yet despite the plan’s popularity with women and men, the Trump administration and conservative members of Congress would like to do away with this comprehensive, affordable coverage.

According to the National Women’s Law Center (NWLC) there is strong evidence for why the benefit is so popular. Before the benefit, costs of birth control amounted to 30-40 percent of women’s out-of-pocket health care costs. For example, the cost of an IUD amounted to a month’s salary for someone working full-time for minimum wage.

Getting rid of the mandatory birth control benefit would mean that once again women would need to make difficult economic choices among methods based on cost rather than what works best for them. Some women would be forced to go without any method if the cost were too high.

For more information on the birth control benefit go to the National Women’s Law Center fact sheet:

The Affordable Care Act’s Birth Control Benefit: Too Important To Lose.

Emergency Contraception

 

History of Birth Control

Before 1800

For centuries, women have tried to regulate their fertility. It is difficult to trace the history very far back because the subject was rarely discussed publicly. Women used almost anything, including herbs, poisonous potions, and even animal poop. People associate iron lock-and-key chastity belts with Medieval torture, but they were not popular until the 19th century. Women were entering the Industrial Revolution workforce, away from home. Fashion magazines advertised chastity belts as a defense against rape. Men sometimes wanted their mates to wear them to prevent cheating and masturbation. In general, however, the most common methods were douching, withdrawal, rhythm, condoms, and pessaries, i.e. devices inserted in the vagina.

19th Century and social purity

Laws did not restrict contraception in the United States through most of the 19th century. But in the 1870s, a social purity movement grew in strength. It aimed at outlawing vice in general, but more particularly, prostitution and obscenity. Some middle-class women joined with Protestant moral reformers. This Victorian-era movement attacked contraception as an immoral practice that promoted prostitution and venereal disease.

Anthony Comstock was a leader in the purity movement. He successfully lobbied for the passage of the 1873 Comstock Act. The federal law prohibited the mailing of “any article or thing designed or intended for the prevention of conception or procuring of abortion” as well as any contraceptive information.

Comstock was appointed to the position of postal inspector. He was proud of the fact that he was personally responsible for thousands of arrests and the destruction of hundreds of tons of pamphlets and books. The books included medical school textbooks which contained anatomical illustrations of human genitals. The more rigorously authorities enforced the Comstock laws, the more contraception went underground. But it was not extinguished.

Advocacy for Contraception Emerges

Thanks to the emergence of advocates such as Margaret Sanger, contraception gradually became more widely accepted. Clinics became more common in the late 1920s. However, the movement still faced serious opposition. Large sectors of the medical community resisted dispensing contraception. Some hospitals would not grant admitting privileges to doctors who advocated birth control. State and federal laws—though generally not enforced—still outlawed contraception.

Tantamount to Murder?

Back then, as it does now, the Roman Catholic Church opposed the use of contraception. On New Year’s Eve 1930, the Church officially banned any “artificial” means of birth control. The Church banned condoms, diaphragms and cervical caps as artificial. They blocked the natural journey of sperm during intercourse. The Church also banned douches, suppositories, and spermicides because they all killed or impeded sperm. According to Church doctrine, tampering with the “male seed” was tantamount to murder. To interfere with God’s will was a mortal sin and grounds for excommunication.

Slow Adoption of Contraception

In 1937 the American Medical Association finally adopted contraception as a normal medical service. However, the medical community overall was slow to accept this new responsibility. Diaphragms were the most commonly used female birth control mechanism before the pill, but that required a doctor’s prescription. In some states, such as Massachusetts, it was illegal for a doctor to make such a prescription. So women continued to rely on unsafe and ineffective contraceptive advice from ill-informed sources until the 1960s.

Religious Refusal

Both the federal and state government have passed laws that give all healthcare providers and groups with religious or moral objections the right to refuse to provide reproductive health services.

“Conscience protections” or “religious refusal” laws use religion as an excuse to discriminate against those who do not share their beliefs. With so few options for access to reproductive health services, women who live in rural areas or low-income women are particularly affected by conscience and refusal laws. There may be no other alternative for these women to turn to for their reproductive health services.

At the federal level, the Trump administration is enforcing “religious” and “moral” exemptions that affect access to reproductive health care. The goal of the administration’s Office of Civil Rights is to enforce laws that protect workers from being forced to violate their beliefs. Thus, hospitals are permitted to turn away patients who need access to reproductive health care. Pharmacists are permitted to refuse to fill prescriptions for birth control. Notably, there is no requirement that personnel who object on religious grounds refer patients elsewhere.

These “conscience protections” allow medical personnel to refuse to provide abortions as well as training for abortion, sterilization or contraceptives, including emergency contraceptives for rape victims.
Health Insurance coverage is also impacted: the decision by the Supreme Court (June 2014, Burwell v. Hobby Lobby) paved the way for employers to deny contraceptive coverage to their employees in their health insurance plans. This decision will affect more than half of American workers.

Many states have enacted their own laws in an attempt to comply with federal law. For example, In Kansas, if a doctor believes a patient might have an abortion if she knew certain information about her pregnancy, the doctor can legally withhold that information with no threat of a lawsuit. In 44 states, healthcare organizations are allowed to refuse to provide abortions. In nine states health care professionals may refuse to provide ALL contraceptive services. In some states, a pharmacist need not refer you to other healthcare professionals who could give you the services or medication you need.

Supreme Court

Ever since the landmark decision Griswold v. Connecticut, which held that the constitutional right to privacy derived from the Bill of Rights, the Supreme Court has heard numerous cases which have impacted the use of and access to contraceptives for American women. These rulings have affected how US citizens have come to view contraception and the right to privacy.

Griswold v. Connecticut

Over fifty years ago two people were arrested in Connecticut for giving birth control to married women. At the time, this was illegal. They were Estelle Griswold, Executive Director of Planned Parenthood League of Connecticut and Dr. C. Lee Buxton, chair of the Yale Medical School Department of Obstetrics and Gynecology. In Griswold v. Connecticut, this case was appealed to the U.S. Supreme Court (1965).

The case was about a Connecticut “Comstock” law that prevented a person from using “any drug, medicinal article or instrument for the purpose of preventing conception.” The court held that the statute was not constitutional. It also held that the law denied disadvantaged people access to medical care and current information on birth control options. By a vote of 7–2, the Supreme Court overturned the law on grounds that it violated the “right to marital privacy” which formed the basis for the right to privacy with respect to intimate practices.

Griswold v. Connecticut and other cases view the right to privacy as a right to “protection from governmental intrusion.”

Eisenstadt v. Baird

Bill Baird was an advocate for reproductive rights most of his life. He is best known for a legal fight that began when students at Boston University asked that he challenge a 19th-century Massachusetts law that prohibited giving contraceptives to unmarried people.

He met this challenge on April 6, 1967, when at a University lecture Baird handed a condom and a package of contraceptive foam to an unmarried 19-year-old woman. He was arrested and given a prison sentence. His appeal launched a court battle that took him to the Massachusetts Superior Court and later to the Supreme Court.
The Supreme Court decision, Eisenstadt v. Baird (1972), established that all people, on the grounds of their right to privacy, should be free from government interference in their reproductive decisions. The 6-1 ruling applies regardless of whether couples are married or unmarried. The significance of the decision was apparent a year later when it was quoted six times in the Roe v. Wade decision which legalized abortion in the United States.

Justice William J Brennan wrote the majority opinion. He stated that, since Massachusetts did not enforce its law against married couples, the law caused discrimination by denying unmarried couples the right to have birth control. He found that Massachusetts’s law was not designed to protect public health and lacked a rational basis.

In a span of less than a decade, Baird’s Supreme Court case and Roe v. Wade established many of the reproductive freedoms we have now.

 

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