People who understand the significance of birth control in a woman's life often talk about Female Contraception as a right. This approach, however well-intentioned, is misguided. In fact, conservatives have successfully dragged the debate about contraception into this terrain to women’s detriment. This is because the "rights" are fraught with moral relativism, which is a losing battle for women - especially when it comes to their sexual freedom. From a practical perspective, rights are not absolute. Something may be a right in one country and not in another.
Something may be a right under religious dogma, but not under the legal doctrine and vice versa. This creates a massive gray area that pulls supporter of female birth control away from the reality of birth control as a medical necessity.
Most recently, the issue of women and contraception has become a focal point through the battle over whether or not under the Affordable Care Act (“Obamacare”) employers should be forced to offer insurance plans that cover contraception. Arguing that contraception must be covered by Obamacare because it is a right misses the mark and takes proponents on a pointless quest. The real question should be the following: why should female contraception be treated any differently than any other prescription medication?
In other words, the question shouldn’t be why contraception should be covered but why it shouldn’t be covered. Framed that way, opposition has to both come out of the shadows as hostile to women's autonomy and, by doing so, loses some of its appeal.
Obamacare-compliant insurance carriers offer no-cost female contraception.
Obamacare requires insurance carriers to offer “Essential Health Benefits” and specifies that the essential health benefits package must cover a number of general categories of services including prescription drugs, rehabilitative and habilitative services and devices, and preventive and wellness services and chronic disease management.
Based on this, Obamacare-compliant insurance plans cover one type of birth control per person from each of the 18 FDA-approved categories. Obamacare-compliant insurance plans also cover the following drugs: asthma medication, insulin, Viagra, blood pressure medication, and cancer treatments. Obamacare also covers Hep B screening for adults at high risk, Hep C screening for adults at high risk, HIV screening for everyone ages 15 to 65, STI prevention counseling for adults at high risk, and syphilis screening and treatment for adults at high risk.
Nobody is up in arms about those services, yet if one wanted to talk about “responsibility” and “morality” certainly these services would be in the same finger-wagging bucket as female contraception. But that doesn’t happen—because the former are all unisex while the latter is strictly female.
This position double standard opens the door to an effective and straightforward response: women want to have access to affordable contraception because it is a basic medical service and necessity, the same way STI testing, blood pressure medication, and asthma drugs are. Not being pregnant allows women the very basic right (and this is a right) to govern their own life: when to take professional risks, when to save up, when to buy a certain house, when to move across the country, when to go to school, and many other decisions affected by childbearing.
When framed this way, contraception becomes a medical necessity in the same way blood pressure medication, anti-depressants, insulin, and other prescription medications are necessities. Without contraception, women cannot both be sexually active adults and have control over their own reproductive lives. They have to resort to one of two things: complete abstinence or reliance on men to use male based contraception, such as condoms. Either way, they have to give up control of their sexuality by either abdicating it or handing it over to their male partners. That is both unacceptable and not something we ever dream of asking from men.
Women, religious and not, overwhelmingly use female contraception, debunking the "conscientious objector" myth.
To further strengthen this argument, let’s debunk some myths about who uses contraception. Despite hand-wringing about the “irresponsible” and “debauched” unmarried women needing their “whore pills,” 77% of married women use contraception while only 42% of never-married women use contraception. Why? Because, as reported by the Guttmacher Institute, married women are the most likely to be sexually active. Among sexually active women, 93% of married women use contraception while only 83% of never-married sexually active women use contraception. The religious-based opposition is likewise disingenuous when we look at the number of religious women using contraception.
A whopping 89% of sexually active Catholic women who don’t want children use contraception and 90% of Protestant sexually active women who don’t want children use contraception. Also according to the Guttmacher Institute, “[a]mong sexually experienced religious women, 99% of Catholics and Protestants have ever used some form of contraception.” So do the remaining 10% of Catholic women use natural forms of birth control? No, “[o]nly 2% of at-risk Catholic women rely on natural family planning; the proportion is the same even among those women who attend church once a month or more.” Based on this, religious opposition to providing health insurance which, in turn, covers contraception is—in plain terms—nonsense.
(For more data from the Guttmacher Institute on US contraception use visit
The religious-based opposition is likewise disingenuous when we look at the number of religious women using contraception. A whopping 89% of sexually active Catholic women who don’t want children use contraception and 90% of Protestant sexually active women who don’t want children use contraception. Also according to the Guttmacher Institute, “[a]mong sexually experienced religious women, 99% of Catholics and Protestants have ever used some form of contraception.” So do the remaining 10% of Catholic women use natural forms of birth control? No, “[o]nly 2% of at-risk Catholic women rely on natural family planning; the proportion is the same even among those women who attend church once a month or more.” Based on this, religious opposition to providing health insurance which, in turn, covers contraception is - in plain terms - nonsense ( more data on US contraception can be found on the Guttmacher Institute's website).
Unfortunately, this argument won the day in 2015, hurting all women and aiding a few rich men.However, the fact remains that the vast majority of women, whether religious or not, married or not, use contraception. Why? Because it is a necessity.
Contraception is a prescription drug/device like any other
Nobody questions whether health insurance should cover anti-depressants or blood pressure medication or insulin or, of all things, Viagra. Also, nobody argues there is a right to any of these, yet they are covered. What needs to happen is a paradigm shift. The conversation must no longer be about whether contraception is a right but whether there is any legitimate reason to treat contraception differently than we treat other prescription medications that help people maintain the status quo with respect to their health.
Insulin doesn’t cure diabetes; it maintains a status quo so that people taking it can continue going about their life. Anti-depressants don’t cure depression; they allow a person to maintain mental health status quo so they can go about their life. Blood pressure medication does not cure high blood pressure; it maintains the status quo (low blood pressure) so people can go about their lives. Similarly, contraception maintains the
Insulin doesn’t cure diabetes; it maintains a status quo so that people taking it can continue going about their life. Anti-depressants don’t cure depression; they allow a person to maintain mental health status quo so they can go about their life. Blood pressure medication does not cure high blood pressure; it maintains the status quo (low blood pressure) so people can go about their lives.
Similarly, contraception maintains the status quo (lack of a pregnancy) so women can go about their lives. Nobody asks whether diabetics have a right to their insulin: Did they eat right? Were they irresponsible in their lifestyle choices? Nobody asks whether people taking blood pressure medication have earned it: Did they avoid eating red meat? Did they exercise? Did they quit smoking? Nobody even asks if STI testing is a right: Did these people have unprotected sex? Are they being promiscuous? In fact, no other healthcare service carries with it the moral judgment foisted on female birth control.
Contraception is critical to keeping women and mothers healthy, happy, and productive.
Contraception allows women to have healthier pregnancies, to space births, and to limit their family size as desired.
In addition, pregnancies that are too frequent or too late or too early in a woman’s life have negative health consequences. Finally, women’s ability to control their childbearing has a direct positive impact on their ability to participate in the workforce, on their pursuit of education, on their mental health, their happiness, and their children’s happiness. The latest numbers out of Texas regarding its maternal mortality rates are just a reminder of the devastatingly negative impact of low access to reproductive health services.
Life, liberty and the pursuit of happiness - for all!
As a society, we strive for people to have equal access to opportunities. Indeed, the “pursuit of happiness” is a right recognized by our Founding Fathers.
Public figures keep underscoring how important it is for every citizen to be productive and to contribute to our economy and to reach their full potential. Yet when it comes down to women, we tell them that we expect them to do all those things but they’re not allowed to control the one thing that can truly get in the way: their reproductive lives. Birth control allows a woman to plan when she’s going to go to school, when she’s going to get a job, when she’s going to live in a certain city, when she’s going to make particularly significant investments of time and energy into her work, into herself, into her marriage, and into other aspects of her life. Contraception allows women to decide when and how to invest their human resources: their time, their energy, their affection and their intellectual capacities. Contraception for women is a
Contraception allows women to decide when and how to invest their human resources: their time, their energy, their affection and their intellectual capacities. Contraception for women is a medical necessity because a pregnancy is a long, physically and mentally challenging process. Even easy, wonderful, uncomplicated pregnancies are demanding. And after those pregnancies are over, comes the reality of parenthood. This burden is more heavily shouldered by women, further adding to the double standard.
As a mother of four, I wholeheartedly support women having families and careers. I also know how critical access to contraception was in order for me to get to where I am today. I spaced and timed my pregnancies as I saw fit so that they only minimally interfered with my career. This allowed me to manage things so that I could still reach my goals, including the goal of having (a lot of) children and running a law firm. We cannot both encourage women to Lean In, be leaders, go to school, have careers, join the political world, and do all of the things that we expect and admire women to do, while at the same time telling them that it is immoral for them to control their own bodies.
Finally, opponents of insurance coverage for contraception like to skew the argument by saying they don’t oppose contraception, they just don’t think insurance should cover it. This brings us back to our initial point: Why not? Insurance covers all types of other medication that allow people to have happy, healthy, prosperous lives. It gives people all sorts of ways to manage a variety of issues ranging from chronic disease to chronic pain and anything in between. Contraception is no different. From a scientific and medical perspective contraception is just another way for human beings to maintain the status quo with respect to their body so that they can go on about their business and do all of the other things that human beings are expected to do: work, love, live, have hobbies, travel, raise children they already have without having more.
Don't explain "why" ask "why not?"
Contraception is a medical service. To the extent health insurance covers medical services, it should also cover birth control. So next time someone tells you Obamacare should not force employers to offer insurance that covers female contraception, don’t tell them why it should, ask them why it shouldn’t.
