Every November 13th, we observe Thanks, Birth Control Day. As 99 percent of women in the US will use a contraceptive method at one point or another, birth control should be celebrated. But the Trump administration is doing its best to limit access to contraception at home and abroad. It defies both logic and public opinion.
The ability to space or limit our pregnancies empowers women. It not only gives us better control over our bodies, it gives us greater control of our lives. There are also medical benefits. Birth control helps to treat painful medical conditions like endometriosis. For transgender and gender-nonconforming people, it can ease the distress relating to gender dysphoria. It also has enormous economic benefits. Access to birth control has enabled millions of women to complete higher education and pursue careers. We all should be thankful for birth control.
But tell that to the Trump administration, which has implemented several policies that limit access to birth control. Thanks to a new Trump-era regulation, clinics that actively discourage contraception are now eligible for funding through Title X, a 50-year old program designed to ensure low-income households have affordable access to a broad range of contraceptive methods.
It’s important to recognize that there are several different methods of contraception. What works for one person may not work for another. It’s crucial for an individual to be able to use a method that meets their healthcare needs and suits their lifestyle. But accessing the right method of birth control isn’t always easy. In the U.S., millions of women live in what is called a contraceptive desert. More than 19.5 million women lack reasonable access to a clinic in their county that offers a full range of contraceptive methods. Of these women, 1.6 million live in a county without a single clinic that offers the full range of methods.
Accessing birth control is a protected right in the U.S., but the sad reality is that many are not able to fully exercise that right. And that is becoming increasingly common as access to a full range of contraceptives is being limited by policy barriers.
Title X provides federal grants for comprehensive family planning and preventative services, including contraception. Title X-supported clinics have delivered family planning services to 4 million low-income individuals annually. However, the Trump administration’s new rule, often referred to as the domestic gag rule, is rolling back the program’s progress.
Regulatory changes to Title X are redirecting federal money away from reproductive health-focused providers. Planned Parenthood, which served 40 percent of Title X patients, was forced to withdraw from the program earlier this year. Other providers are also being compelled to make a nearly impossible decision: provide patients with the highest standard of medical care and lose federal funding, or accept the funding and limit the care. The Trump administration’s goal is to force responsible providers out of the program to make way for faith-based organizations.
Rather than ensuring Title X patients have access to the full range of contraceptive options, the Trump administration repealed the former requirement that “medically approved” methods be among the broad range of options available to patients. This means that ideologically motivated providers offering only “natural family planning” and “abstinence-only” are now able to receive federal funding. That may work for a few people, but Title X patients deserve access to the broadest possible range of birth control options.
The Trump administration is also undermining access to contraceptives in developing countries. Globally, an estimated 885 million women of reproductive age in developing countries want to avoid a pregnancy, but 214 million of them are not using a modern method of contraception. That number, however, may increase as many of these women are losing access to U.S.-supported family planning services as a result of the “global gag rule.” The Trump administration insists that the rule will curb abortion, but in practice, it will result in more unintended pregnancies and more unsafe abortions.
The gag rule forces foreign health care providers who accept U.S. government funds to agree not to advocate for abortion or refer patients to abortion services. Many overseas providers of family planning, however, cannot abide by that restriction and are forced to refuse U.S. financial support. As a result, they must reduce staff, curtail services, or even close their clinic doors. That, in turn, means that potentially millions of women lose access to contraception.
It’s entirely right that we give thanks to birth control. But access to a broad range of birth control methods should not be a privilege. As we shout our thanks, we must continue to fight for improved access for all and the elimination of harmful policies.
This op-ed by Population Institute Director of Research Bridget Kelly originally ran on November 13, 2019 in the Daily Kos