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Policy Project: Access to Contraceptives

Abigail Angell

NUR 420-2W1 Nursing Policy

Delaware Technical Community College

Ms. Tammy Layer

August 7, 2022
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The Need for Easy Access to Contraceptives with a Provider's Prescription

According to “The American College of Obstetricians and Gynecologists”, “The benefits

of contraception, named as one of the 10 great public health achievements of the 20th century by

the Centers for Disease Control and Prevention, are widely recognized and include improved

health and well-being, reduced global maternal mortality, health benefits of pregnancy spacing

for maternal and child health, female engagement in the workforce, and economic

self-sufficiency for women. Ninety-nine percent of U.S. women who have been sexually active

report having used some form of contraception…” (ACOG, 2015). Allowing everyone access to

contraceptives would be very beneficial and needed for all women. Allowing women the

opportunity to choose for themselves when or if they want to have a child should be left up to the

women. Allowing this access will decrease the chances of a child being born into poverty and

struggling to find their next meal. Contraceptives, or birth control, should be available to

everyone who wants them. There needs to be programs, funds, and laws that ensure that any

woman has the access and ability to gain birth control if they want to. These women shouldn’t

have to worry about what the co-pay might be or how much they will have to pay to get their

birth control refilled. That is why the focus of this paper will be on bills and laws that are in

place to support the need for access to birth control. There will also be a focus on what the

solution may be in providing this access to everyone and how to go about lobbying for that

stance against lawmakers. This is a topic that is important to discuss and find solutions to

because it not only affects women today but also those in the future, as well as current and future

families.
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The Problem That Needs to be Solved

“Unintended pregnancy and abortion rates are higher in the United States than in most

other developed countries, and low-income women have disproportionately high rates. Currently,

49% of pregnancies are unintended…The human cost of unintended pregnancy is high: women

must either carry an unplanned pregnancy to term and keep the baby or make a decision for

adoption, or choose to undergo abortion. Women and their families may struggle with this

challenge for medical, ethical, social, legal, and financial reasons'' (ACOG, 2015). Women need

access to contraceptives so they don’t have to worry about what they will do if they get pregnant.

If lawmakers try to limit access to contraceptives and do not support the use of them, it will lead

to many unwanted pregnancies and it will lead women and families to struggle with what their

next step will be. This could mean an abortion, put the child up for adoption, or palce them in

foster care. The mom could also decide to keep the baby but then may struggle financially and/or

emotionally and will possibly have to depend on welfare. None of these, except for possibly

adoption, would be in the baby's best interest but it would be the mom's choice to decide what

would be best for her in the current situation. If there was expanded access and funding for

contraceptives and more education on how important they are women would not have to make

these difficult decisions. They would have the opportunity to prevent these pregnancies from

occuring in the first place. That is why it is important to continue to support and push for easy

access to contraceptives with a doctor's prescription. Currently there are some bills and laws

protecting those rights, as well as more bills pending approval.

Current/ Pending Bills

The right to obtain birth control has come a long way since the late 1800s and early

1900s when it was prohibited from being used or distributed. Then after a few major court
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hearings, ultimately the results ended with allowing access to birth control nationwide. There is

worry that birth control could again be difficult to obtain for anyone, not just those who do not

have insurance. The focus now though is allowing every woman the opportunity to have access

to contraceptive methods. Clearly, stated earlier it is important for women to be able to choose

when to have a child and in the long run it is cheaper for everyone when women are not ready to

have children. From Guttmacher Institute it was stated that “ Recently cited estimates of the

one-year cost of providing contraceptives range from $100 to $600, while the costs of prenatal

care, delivery and newborn care under private insurance, according to one estimate, are around

$18,000 for a vaginal birth and $28,000 for a cesarean birth—roughly twice as high as the costs

of these services under Medicaid…In effect, preventing just one additional unplanned pregnancy

among dozens of women would result in cost savings…” ( Guttmacher Institute, 2014). This

only shows the cost of delivery itself and does not include all the things a baby needs in their

first year of life or for the rest of their life. If a woman who is not prepared to have a child, ends

up with an unintended pregnancy and decides to keep the child. It will be difficult for women to

care for that child, it can definitely be done because it is seen done all the time in society, but if

there could have been a way available to them to prevent this pregnancy from occuring, they

may have chosen to wait to have that child. These laws are there to project and spread awareness

of the need for easy and cheaper access to birth control for all women.

One law that was introduced to the Senate on November 17, 2021 and read twice and

then sent to the Committee on health, education, labor, and pensions. This law is S. 2332 and is

titled “Access to Birth Control Act”. This law was created to require pharmacies to comply with

certain rules relating to access to contraceptives. “Pharmacies must provide without delay a

customer with any contraceptive or related medication that is in stock. If the contraceptive is not
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in stock, the pharmacy must immediately inform the customer and either order the contraceptive

or refer the customer to a pharmacy that has it in stock. Laws in some states provide pharmacists

with the right to refuse to dispense contraceptive-related drugs on religious or conscience

grounds. Pharmacies may refuse to provide a contraceptive to a customer if the customer lacks a

valid prescription for a prescription contraceptive or is unable to pay for the contraceptive, or

based on a pharmacy employee's professional clinical judgment” (Congress, 2021). This law was

created to make sure that women are able to receive their contraceptives in a timely manner with

a doctor's prescription. These pharmacies can not just state that they do not have the medication

and not do anything to help the patient retrieve their medication. Birth control needs to be taken

around the same time daily if it is not the women's hormones will be scattered and there could be

the possibility of her becoming pregnant.

Another bill that was recently introduced in June of 2022 was expressing support for

contraceptive rights and access across America. The bill titled H. Res. 1155 is still in the

beginning stages of becoming a law, it was introduced by the House of Representatives and then

sent off to a couple committees. This policy was expressing support in giving women the option

to use birth control. It stated that “ Whereas the ability to prevent, plan, and space pregnancies is

critical to people’s educational attainment and economic advancement, and has been vital to

advancing equal opportunity and economic security for women…” (Congress, 2022). Women

have the right to decide when and if they use birth control and that decision is crucial and

important for them to make based on where they are in life and what goals they want to achieve.

This is why it is important to talk with lawmakers and make sure they continue to allow women

the access and right to contraceptives.

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Lawmakers/Representatives that Need to Be Contacted

In order to take action and protect a woman’s right to obtain birth control if she desires to,

the public needs to address our lawmakers and make sure they are aware of how important this

is. Below is a list of local, state, and federal leaders that can be contacted to protect the use and

education of contraceptives.

https://www.graham.az.gov/191/Board-of-Supervisors The local officials for Graham

County, AZ are Paul David, John Howard, and Danny Smith. These men are a part of “ The

Board of Supervisors which is the governing and policy-making body of Graham County. The

Board is empowered to perform acts necessary to fully discharge its duties as the legislative

authority of County government. The powers of the Board are very broad in nature…” (Graham

County, n.d.). Contacting these people would be the first step in explaining and implementing a

plan to continue to offer birth control and education on birth control to all women. Later it will

be discussed what specifically will be placed in front of them and how this will hopefully prevent

them and the following individuals from defunding programs that help pay for support, birth

control use and education. The board of Supervisors can be contacted via the link above or by

phone at 928-428-3250.

https://www.azleg.gov/memberroster/ The state leaders in Arizona that can be contacted

that represent this part of graham County, which is district 14, are Lupe Diaz, Gail Griffin and

David Gowan. These people are part of the Senate and House of Representatives here within

Arizona. In order to contact them there would need to be use of the link above and this link

contains their emails and phone numbers.

https://www.graham.az.gov/478/Elected-Officials The federal elected officials that are in

the United States Senate and United State Congress that represent Arizona are Krysten Sinema,
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Martha McSally, and Tom O’Holleran. Their phone numbers and emails are shown within the

link above.

https://www.arizonafamilyhealth.org/our-work/ The Arizona Family Health Partnership

has clinics across Arizona to help with providing reproductive health and education to all women

who need it, but the main focus is on women who are unable to afford the care they greatly need.

This organization helps to organize funds provided through the federal Title X funding program.

This program also looks to educate legislators and advocate for the necessity of having these

programs and providing this care and opportunity to all women.

These are the people we need to contact to make sure contraceptives and education on

them are still performed for all women and that the right to obtain contraceptives are not taken

away from them. The group mentioned above will also need to be someone that is contacted

about helping and supporting that decision to have a policy in place that protects all women and

guarantees them access to birth control. The following will include strategies to be used when

trying to prevent laws from being created to restrict the use of birth control. As well as a few

talking points to provide information on why allowing all women the right to access birth control

is important and what the plan is for the next 90 days to implement this change in the community

and possibly the nation.

A Clear Solution Provided

Having a clear solution for this issue is very important for all women and families, having

programs available to help pay for and find the birth control that works for them is very

important. In order to create this program lawmakers need to be on board with lobbying and

finding ways to help fund the programs. To prove and explain the importance of having a plan in

place to protect these women and their right to receive and use birth control, there will be four
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talking points that will be discussed with the lawmakers to explain and show the importance of

having a solution in place for these women.

First, it should be within a woman's right to choose when and if she wants to get pregnant

because pregnancy can take a toll on the body and can be financially expensive. “Ensuring

access for all people to their preferred contraceptive methods advances several human rights

including the right to life and liberty, freedom of opinion and expression and the right to work

and education, as well as bringing significant health and other benefits” (WHO, 2020). Having

access and control over their body is within their right to choose when to have a child and family.

Having access to contraceptives will lead to more women and families being ready to have and

raise a child.

Second, having access to contraceptives can not only prevent unwanted pregnancies, but

it can help families and mothers plan out safely when they want to have their next child. From an

article from the World Health Organization it stated that “...when births are separated by less than

two years, the infant mortality rate is 45% higher than it is when births are 2-3 years apart and

60% higher than it is when births are four or more years apart” (WHO, 2020). Contraceptives

allow women to safely plan their families in a way that will prevent pregnancy related health

concerns that can occur if a woman becomes pregnant again too soon after just being pregnant.

Third, allowing and giving continued access and support to women to obtain

contraceptives will lead them to possibly seek continued education and higher paying jobs.

Accordinging to the Joint Economic Committee, “ Research suggests that access to birth control

at an earlier age improves economic outcomes for women, such as increases in educational

attainment and labor force participation. One study found that college enrollment was 20 percent

higher for women who had legal access to birth control than for those who did not. Women with
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earlier birth control access were also less likely to leave school before earning their degree”

(JEC, 2020). This means that women have early access to birth control and are more likely to

further their education and careers. Then this leads to a significant reduction in female poverty as

stated later in the Joint Economic Committee’s article.

The fourth point that would be introduced is how cost effective it is to provide easy

access and programs that assist women in obtaining contraceptives. As mentioned earlier,

funding programs and providing women with that opportunity to obtain birth control is still

immensely more beneficial and cheaper for everyone than women becoming pregnant when she

is not ready or prepared for a child. According to Guttmacher’s Institute data “...shows that by

helping women avoid unintended pregnancies, public funding for contraceptive services resulted

in net public savings of $10.5 billion, or $5.68 for every dollar spent” (GT, 2014). As stated,

funding programs that supply women with contraceptives at a reduced or free price will save

more money in the future than not funding these programs.

These important points lead to and prove how important it is to make and keep

contraceptives available for all women. There are programs and funds that have been created but

these programs are beginning to be restricted, which will not help anyone in obtaining birth

control or continuing on it. The funding that is available are programs that offer contraceptives to

women at a free or reduced price. These programs are “...a network of public programs and

providers have assisted millions of low-income women of childbearing age in the U.S. to obtain

sexual and reproductive health services. Medicaid, the Title X Family Planning Program, and

Section 330 of the Public Health Service Act (PHSA) provide critical support to more than

10,000 safety-net clinics across the country that provide reproductive health services to

low-income women, men, and teens” (Gomez et al,. 2019). Medicaid is a program that was
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created to support low-income individuals and families obtain the healthcare they needed, this

includes family planning opportunities like contraceptives. Title X is the only federal program

specifically dedicated to the delivery of family planning care. Section 330 grants provide core

support to the nations Federally Qualified Health Centers (FQHCs), the largest system of

providers who provide care to poor and underserved patients. Recently, though, policy changes at

the state and federal level in Medicaid and Title X have restricted providers from receiving

federal and state funds for family planning services (Gomez et al,. 2019). Since this funding

could be and is being restricted it could impact how many women are able to receive these

services. That is why it is important to make sure lawmakers know how important it is to have

this funding and places where women are able to speak with a provider and find and receive the

birth control that is right for them.

A Brief Overview of the Future and the Goals in Mind

Over the next 90 days to make sure this solution is known and presented to the

lawmakers and people that can make a difference there needs to be a plan in place to make sure

this solution is known. First there will need to be information spread throughout the community

to raise awareness of how important it is to continue to provide contraceptives to all women who

want them. Next when there is more community support and awareness it will need to be

presented to the local lawmakers and explained how important it is to continue to fund and

support programs that help women attain the contraceptives that work for them at a reduced or

free cost. Once local lawmakers have been spoken to, hopefully this will lead to support from

them or at least they will continue to be open to listening and hearing how important this is.

After this it will mean taking this solution and need, to national leaders to hopefully prevent
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them from defunding programs that support family planning and women in gaining

contraceptives.

Throughout this process there is hope that first, people will understand how important it

is to have family planning services available to all women who want to use those services.

Women having the opportunity to choose for themselves when and if they want to have children

is important for them and their families. Women have the right to that opportunity and

throughout this process hopefully people and lawmakers will see the value in keeping and

funding programs to support the distribution of contraceptives. Second, there is hope that having

contraceptives available and having them offered at a decreased or no cost will lead to more

women using them and prevent any unwanted pregnancies and allow women to accomplish what

they want before having children, leading to those families most likely living in a better place

financially. This will definitely not prevent all unexpected pregnancies but if there was more

awareness and if it were easier for women to pay for contraceptives I feel this would greatly help

prevent many of those unexpected pregnancies.

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References

Congress. (2022, June 7). H. Res. 1155- Expressing support for contraceptive rights and access

in the United States and expressing the sense of the House of Representatives regarding

comprehensive reproductive health care.

https://www.congress.gov/bill/117th-congress/house-resolution/1155/committees?q=%7B

%22search%22%3A%5B%22contraceptives%22%2C%22contraceptives%22%5D%7D

&r=2&s=5

Congress. (2021, November 17). S. 3223-Access to Birth Control Act.

https://www.congress.gov/bill/117th-congress/senate-bill/3223/text

Graham County. (n.d.). Board of Supervisors.

https://www.graham.az.gov/191/Board-of-Supervisors

Gomez, I., Ranji, U., Salganicoff, A., Sobel, L. (2019, October 25). Financing family planning

services for low-income women: the role of public programs.

https://www.kff.org/womens-health-policy/issue-brief/financing-family-planning-service-

for-low-income-women-the-role-of-public-programs/#:~:text=Title%20X%20clinics%20

are%20also,reimburses%20for%20specific%20clinical%20services.

Guttmacher Institute. (2014, July 16). Good for Business: Covering Contraceptive care without

cost-sharing is cost neutral or even saves money.

https://www.guttmacher.org/article/2014/07/good-business-covering-contraceptive-care-

without-cost-sharing-cost-neutral-or-even#

Joint Economic Committee. (2020, February). The economic benefits of birth control and access

to family planning.
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https://www.jec.senate.gov/public/_cache/files/bb400414-8dee-4e39-abd3-c2460fd30e7d

/the-economic-benefits-of-birth-control-and-access-to-family-planning.pdf

The American College of Obstetricians and Gynecologists. (2015, January). Access to

Contraception.

https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/01/acce

ss-to-contraception

World Health Organization. (2020, November 9). Family planning/contraceptive methods.

https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception