Until we start treating health care as a human right, we’ll continue to struggle to achieve equality and reproductive freedom.
I began using contraception as a high schooler in small-town Nebraska, when I went on birth control for irregular periods and acne. By the time I had a sex life, in college, I had access to health care through the university. Its clinic offered affordable contraception but no contraceptive counseling.
It wasn’t until I was in my 30s, when I found a compassionate and responsive health care provider, that I learned about other family planning options: IUDs, diaphragms, patches and shots. Before that, I thought the pill or condoms were my only options.
These days it may be easier to find information on the type of contraception that’s best for you, but the battle for equitable reproductive health care is far from over.
Reproductive Freedom Requires Contraception
On Nov. 10, the Supreme Court once again heard arguments challenging the constitutionality of the Affordable Care Act, including guaranteed access to contraception. Recently confirmed justice Amy Coney Barrett has publicly criticized the ACA—though it provides access to affordable contraception and lifesaving health care coverage to 20 million Americans. Her opinion could decide the law’s fate.
This attack on contraception coverage is an attack on reproductive freedom—an unpopular one. A recent nationally representative survey by the Center for Biological Diversity (where I work) found that 80 percent of respondents agree that all types of birth control should be legal, free and easily accessible.
Free contraception would have been a blessing when I was in college—just as it is today for students who are supported by the no-cost contraception coverage of the ACA. When it’s not, low-income and marginalized communities suffer the most due to systemic racism, poverty and sexism.
Black women have greater difficulty getting contraception and face greater pregnancy risks associated with climate change. They also experience worse pregnancy outcomes due to inadequate health care access and other economic and social pressures caused by systemic racism. Black communities disproportionately experience gaps in appropriate reproductive health care and exposure to toxic pollution.
In Cancer Alley, in southern Louisiana, residents not only suffer from higher rates of cancer from toxic chemical air pollution, but per capita COVID-19 death rates are higher too. Unfortunately these areas also have an unmet need for health care providers.
Overall 19 million people are in need of publicly funded contraception, and 95 percent of them live in areas that lack health centers offering a full range of contraceptive methods. These are known as contraceptive deserts.
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The 2020 Election
Health care has always been of utmost importance to voters, and the 2020 election was no different. As Americans cast their votes among a raging pandemic, COVID-19 job losses meant that an estimated 4 million women are facing the loss of their employer-sponsored insurance, affecting nearly one-in-10 women who obtain sexual and reproductive health care.
Abortion ballot measures in Colorado and Louisiana show the divide on the issue. Colorado, one of seven states that currently doesn’t prohibit abortion at any point during a pregnancy, struck down a measure that would nearly have banned all abortion measures after 22 weeks of gestation, the stage at which proponents argue a fetus could survive outside the womb.
On the other hand, Louisiana joined Alabama, West Virginia and Tennessee in approving a constitutional amendment expressing that those states offer no protection for the right to an abortion, meaning it will be difficult to keep abortion legal in the state if Roe v. Wade is overturned.
Continued gridlock in Congress and the potential alteration or repeal of the ACA next year by the Supreme Court could leave more people vulnerable. Our current members of Congress, who have devised no health care backup plan if the ACA is rescinded, are out of touch with the millions of Americans struggling even more because of the pandemic.
Biden Administration Offers Reason for Hope
Under a Biden presidency, there’s good reason to believe, reproductive health care will once again be treated as a human right.
One of the first things President-Elect Biden will most likely do is rescind the Mexico City Policy, also referred to as the global gag rule, which 70 percent of Americans favor ending. This policy—which denies U.S. funding to health clinics around the world that provide information or services about legal abortion—has been a political football since the Reagan administration, with Democratic presidents rescinding it only to have every Republican president reinstate it.
But President Trump expanded this policy further than ever before by prohibiting any foreign nongovernmental organizations from receiving U.S. global health assistance if they provide information, referrals or services for legal abortion or advocate for the legalization of abortion in their country.
This harmful policy undermines access to contraception, HIV/AIDS services and maternal health care, contributing to more unintended pregnancies and more unsafe abortions. Supporting international family planning and reproductive health programs is essential to empowering women and improving the health and lives of millions of people.
Domestically Biden could reverse the Trump administration’s Title X rule, which undermines the Title X program by promoting natural family planning over other contraceptive methods. It emphasizes discredited abstinence-only messages among adolescents and blocks funding for clinics that provide, refer or discuss abortion services.
Under this “domestic gag rule,” reproductive health care services in low-income communities across the country have decreased by half. By reinstating a comprehensive Title X program, President Biden could once again increase the availability of quality health services for those who need it.
Reproductive Health and the Environment
President-Elect Biden has indicated he plans to rejoin the Paris Climate Agreement, a global effort to tackle climate change. According to a 2018 United Nations report, climate change and its effects disproportionately affect women globally, as many are highly dependent on local natural resources.
While no one is immune to climate change, women are among the most vulnerable, since they’re more likely to become victims of scarcity, drought, food insecurity and increased disease. Without appropriate health care access and autonomy over one’s reproductive future, educational and economic opportunities can become limited. The climate crisis only exacerbates the gender divide.
My experience accessing contraception informs my fight to ensure others have access to contraception today and in the future. Until we start treating health care as a human right, we’ll continue to struggle to achieve equality and reproductive freedom.
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