Birth Control Is a Journey Everyone Should Have Access to

The power to choose the path you take in life is closely connected to access to birth control. Yet, barriers remain when it comes to reproductive autonomy over choice of contraception.

A collage from #ThxBirthControl Day in 2020. (Instagram)

A year before I graduated from medical school, I proudly witnessed my mother overcome challenges and graduate from college—which for a long time was merely a dream deferred for my mother of nine. It is not lost upon me that the divergent path of my life compared to my mother’s was in large part due to my power to decide. Being able to decide if, when and under what circumstances to get pregnant and have a child has allowed me to have a family on my timeline and a fulfilling career.

Unfortunately, the ability to access contraception is largely dependent on an individual’s zip code, insurance status and income level. Currently, in the United States more than 19 million women in need who are of reproductive age live in contraceptive deserts. These are areas where people lack reasonable access in their county to a health center that offers the full range of contraceptive options. For many of these people, seeing a healthcare provider, accessing trusted information, and finding the right birth control is nearly impossible.

Fortunately, there are efforts in place to increase access to all methods of contraception. Policies such as pharmacist prescribing, expansion of telehealth and extending supply of contraception are innovative and effective approaches that center people’s reproductive health. In addition, efforts to make the contraceptive pill available over-the-counter will also help ensure equitable access to a basic form of health care to more people. When people have access to high-quality, affordable birth control they are better able to plan their families and their lives.

The ability to access a method of contraception is only part of the challenge. Finding the right birth control method takes time and can change as your life and priorities change. A method that fits a person’s lifestyle in their 20s may not work for them in their 30s. People get on birth control for a variety of reasons—some use it to help manage migraines, endometriosis or PMS. Others use birth control to delay pregnancy or prevent a pregnancy. An individual’s birth control journey is unique to them and their needs.

A key step to finding a birth control method that works for you is to find a provider that listens to your needs and priorities. Effectiveness, reversibility, costs and side effects are all aspects of birth control that should be discussed when choosing a method. Some providers make the mistake of assuming that effectiveness is the most important characteristic and may therefore deemphasize or ignore methods like condoms, the pill or fertility awareness. A provider should not only listen to your priorities but respect the factors that are most important to you, without judgement or condescension.

In order to ensure all people have access to the right method of contraception, we must acknowledge the mistrust of the medical system, particularly as it relates to reproductive health that often exists among people of color and people with low incomes. Forced sterilizations, unethical experimentation and other coercive actions have made these communities reluctant to seek and trust reproductive health care and certain birth control methods such as long-acting reversible contraception (LARC). To move forward, the medical community must acknowledge these wrongs and work to regain trust by addressing justifiable skepticism and mistrust. We cannot pretend this dark history is not real, just as we must not let the historical missteps and injustices of the past deny reproductive well-being and autonomy for people today.

Even in the face of these challenges, I am hopeful that we can continue to move in the right direction with policies and practices that center the reproductive health and well-being of all people. I am thankful I had access to all forms of birth control that allowed me to complete my goals and live the life I wanted.

Wednesday is Thanks, Birth Control Day, where we all have an opportunity to tell our unique birth control story. By using #ThxBirthControl across social media, you can share your story and discuss what birth control means to you. Our efforts will help break down the stigmas associated with birth control and amplify how birth control plays a critical role in people’s ability to live life on their own terms, as it has in mine.

Take Action

To help a person living in need of contraception, consider donating to BCBenefits, Power to Decide’s Contraceptive Access Fund. This fund helps people of low income overcome some of the most commonly faced barriers in access to contraception, such as transportation.

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Raegan McDonald-Mosley, MD, MPH is the CEO of Power to Decide.