Celebrating Birth Control on Mother’s Day? Not as Counterintuitive as It Sounds

On Mother’s Day, we honor the women in our lives for all they do–meal planning, financial planning and family planning, to name a few. Regrettably, the latter task is going to cost mothers even more, as coverage for reliable birth control and related services comes under increasing challenge in the U.S.

Last week, Gov. Jan Brewer of Arizona signed a bill banning any state funding from going to Planned Parenthood, the state’s largest provider of basic gynecological care and family planning services, serving more than 70,000 patients a year. Arizona is not alone. Last year 43 states attempted to reduce funding to Medicaid, the major public-funding source for family planning services, and nearly all governors envision additional cuts this year.

Birth control and motherhood may appear to be competing goals. But studies show that the typical American family today wants two children and, according to the Alan Guttmacher Institute, women typically must use reliable contraception for three decades to achieve this goal. Consequently, over 99 percent of women age 18-44 who have been sexually active have used contraception at least once. Today, among the 43 million fertile, sexually active women who do not want to become pregnant, 89 percent are using contraception. Aside from condoms, women bear most of the out-of-pocket costs for contraception.

Some individuals hold strong personal beliefs about the use of birth control and should not be required to use it.  But the costs of contraception–or of discouraging its use–need to be well understood.

The National Bureau of Economic Research recently reported that the pill is responsible for the narrowing of the gender wage gap by 10 percent in the 1980s and by 30 percent in the 1990s.  Moreover, reliable birth control contributed to economic development by reducing women’s risk of dropping out of school associated with early childbearing and high fertility rates, contributing in turn to increases in women’s labor force participation, the continuity of their careers, and the standard of living of women, children and families.

Recent studies by the Guttmacher Institute and Brookings Institution demonstrate that every public dollar invested in contraception saves roughly $4 in Medicaid expenditures–or $5.1 billion in 2008–not to mention the broader health, social and economic benefits. A 2010 California study found that every dollar spent on a Medicaid family planning program saved the public sector more than $9 over the next five years by averting costs on public health and welfare that would have otherwise been incurred. In the private sector, over two decades of research has shown that the availability and use of highly reliable birth control reduce employee absences and turnover, particularly among women who would otherwise face unintended pregnancies. Indeed, it costs insurers and employers more not to provide contraceptive coverage.

And yet, for the first time in two generations, contraception is becoming harder to obtain. State and federal policies that reduce access to family planning services and contraception mean that individual women bear the cost for birth control–an additional $500 or more a year in the case of women with no insurance.

Such policies will allow insurers to profit directly from the considerable savings associated with these women’s use of birth control. Employers, states, and the general population will become “free riders,” enjoying the broader social and economic benefits while individual women shoulder the costs. What’s more, the public costs are only likely to rise as more women have less access to reliable contraception and are put at increased risk of remaining or becoming members of low-income households.

Should women bear the financial costs of contraception? Alternatively, might the costs and benefits be equitably distributed?

Consider for a moment what access to reliable birth control has done for you and your family. What are the costs you and society as a whole would bear from constraining access to birth control versus the benefits of eliminating cost sharing so that all women who want to do so can obtain highly reliable birth control?

Given that women bear the physical burdens of pregnancy and child birth, we would do well to honor mothers–and all women–by establishing policies that share the costs of birth control among the beneficiaries. Not only would it be equitable, it would be cost-effective.

Chloe E. Bird, a senior sociologist at the nonprofit RAND Corporation, is co-author of Gender and Health: The Effects of Constrained Choices and Social Policies (Cambridge University Press, 2008).

Image from Flickr user cambodiaforkidsorg via Creative Commons 3.0.


  1. Angelica Hernanadez says:


    Congratulations! Angelica (op-ed seminar)

  2. Patty Smith says:

    IMHO the reason this and other such funding is being cut for the middle class and poor is to make the masses poorer, less educated and more willing to do whatever the upper 1% want…kind of a corporate way of saying “keep them barefoot and pregnant.” If women have less money, they have less of a ‘voice’ and if they’re pregnant and having babies, they have less money and less power. It’s very sad, but it just makes me want to fight harder to protect the rights of women, the poor, and other minorities.

  3. Kimani M. Kimani says:

    Chloe, Congratulations for Good Work!

    A Down-to-Earth, Thoughtful and Concise Presentation. All Things Being Equal, it Would be a No-Brainer!

    My Contextual Mantra Today, is that ” Any Human & Societal Concern could be Resolved, in Authentic Conversations, in a Mutual Space of ” Respect, Integrity, Good Will and a Commitment to Workability, for All of Humanity, with no One Left Behind”.

    Now, Generating this Kind of “Space” May Demand that All the Us Commit to Giving up the Default “Survival Stereotyping”, and Take on Being Responsible for Resolving the Concern(s), Once and for All.

    We will Need to Transform the Default Notion, that “Women’s Sole Purpose in Life, in the Human Society, is Giving Birth and Raising Children” (with the Men Being the “Bread Winners”) ….to a New Reality, that Bearing and Raising Fully Functioning Children, Does not Exempt Women from the Ability of Contributing Fully, Effectively and Powerfully in Every Other Aspect of the Human Endeavor, at the Same Time. Everyone will be the Better off for it.

    I Say 😕

  4. Allen Fremont says:

    This is a really thoughtful and timely commentary that can help move the conversation about covering the costs of birth control forward. Thanks for writing this.

  5. Leila Taaffe says:

    You go, girl. I am sending this to all the women in my family for Mother’s Day.

  6. Kristi Williams says:

    Well said, Chloe. Sharing widely!

  7. Krasimir Karamfilov says:

    Great op-ed, Chloe. Policymakers must make reliable birth control available for free, or for a minimal cost, for all women, regardless of social status. They need to see it as a social good that benefits all people, and society as a whole on every level.

  8. Meena Fernandes says:

    I did not think of motherhood and birth control this way, but but you are very right and this piece speaks at a personal level on an important issue. It’s great that you worked in all these interesting studies too. Also, I’m sure you have seen it, but I like the latest issue brief from Kaiser on how ACA affects women on Medicaid.

  9. Usha Ranji says:

    Thank you for this thoughtful and important analysis on an issue that is at the heart of women’s health and well being.

  10. Thank you all for your comments. I greatly appreciate the feedback.

  11. Donna Barkman says:


    My mother served six tours of duty,
    children born from 1917 to 1937.
    She stacked and shuffled war stories and dealt them
    judiciously to amuse, beguile, embarrass, enrage
    discourage daughters from the marriage-
    to-babies march she’d found concussive.

    She rejected Mother’s Day for its Hallmarked
    sentimentality – 364 days of women’s unpaid labor
    then one day of recognition, provoked by guilt, obligation
    and love, some love, thanks for the card, the candy.
    No Veterans or Memorial Day parades that reward
    service and sacrifice, no medals, no stripes, no promotions.

    Eighty years later combat prevails as we dispute
    and defend decisions, the bearing of children an issue
    too big for the individual woman, the weaker sex,
    but for male legislators to determine, along with drone attacks
    and punishing foreign sanctions, the work of Sanger
    and Rich notwithstanding. Of Woman Born, indeed.

    When and how will we honor the non-mother,
    the childless woman, the conscientious objector
    who’s resisted the expected, who serves alone
    on principles sacred to her. And worse: we dare not
    acknowledge the regret of the woman who finds too late
    that she hates the olive-drab mother-shawl she’s draped in.

    No honorable discharge exists for mothers. Like some
    soldiers, like Supreme Court judges, like those convicted
    of murder in the First Degree, they are Lifers.
    My mother knew that. She didn’t want to be a deserter,
    but to wage wrathful battles against hardship — and for choices,
    independence and cultural validation of her warrior worth.

    Donna Barkman, 2012

  12. Gail Boyer Hayes says:

    Excellent piece. We forget our gains are so recent and so fragile.

    • Gail,
      Thank you so much for your comment. It is so clear that women’s reproductive health remains far from fully protected for most women even in our country.

  13. “It is so clear that women’s reproductive health remains far from fully protected for most women even in our country.” — Chloe

    Definitely agree. It seems to me that right-wing conservatives are more determined than ever to turn back the clock on women’s reproductive rights. When you read some of the history on the birth control movement in the early 20th century — and how many conservatives at that time were strongly opposed to any form of birth control — it becomes very clear how hard we have to fight to keep those rights.

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