SOME MONTHS back, Planned Parenthood, other women’s health groups, and various Democrats were very vocal in their support of the proposal to make birth control pills available over-the-counter. Arguments were made for its safety, for the benefit to women who could not get to a doctor in time to renew a prescription, for the benefit to those who did not have health insurance or a local clinic, and for increasing what the pharmaceutical companies like to call “compliance” to the Pill protocol.
Then the Republicans got on board this month, with several stating support for the move to remove doctors from this equation. Quickly, those on the other side of the political fence that had previously campaigned with the same message, argued that now a selection of health insurance providers have made the Pill “free” (if you don’t count the monthly premium) for women, transitioning to over-the-counter availability would make it unaffordable for some. Momentarily sharing the same platform, the Democrats soon pushed the Republicans off-stage to take back their position as the only political party that cares about women.
At this time, not one pharmaceutical company has actually applied to make their product available without prescription, so this is a theoretical debate at best. Democrats have called the Republicans seemingly-odd change of heart a “cynical ploy” to gain female votes, because apparently the Republican Party is the only one interested in female voters. The Democrats, of course, are in politics purely for the love of people and not power.
There seems to be something entirely missing from this conversation. Oh, yes — how about any type of concern for women’s experience of side effects, both life-threatening and quality-of-life threatening? The Democratic perspective is one focused solely on access and compliance. Despite the death and injury of many women from popularly prescribed pills like Yaz and Yasmin in recent years, there’s little concern that, with even less caution than is exhibited now, providing these drugs might put more women (particularly those with contraindications such as genetic disposition, weight gain, or a smoking habit) at risk of serious complications.
That’s not to say the quality of care when it comes to contraception appears to be very high with prescribing the Pill – I’ve heard from many women who have visited their doctor with clear signs of a blood clot, only to be told it could not possibly be and just to cool it with the daily runs for a while.
It’s possible over-the-counter availability, and the subsequent price hike (if this were to occur as we have been told), would lead more women to take up insurance-covered methods like the implant or hormonal IUD, which are not without their own problems. Prior to the Affordable Care Act, women with restricted ability to renew a prescription might have been persuaded to use a long-acting hormonal method instead.
As someone who has written a book critical of the over-prescription of the birth control pill, it might be expected that I would be against over-the-counter availability. However, in my view, this move might give women more freedom of choice and control. At this time, doctors act as the salespeople in this transaction. They receive kickbacks for recommending certain drugs. Sure, a woman might be persuaded to try a certain brand by the commercials on television and in magazines, but if she suffers with side effects from that brand, she is likely to be encouraged to give it “just a few more months” by her doctor.
If she’s tried several brands and all have caused her health issues, it’s her doctor who is likely to suggest yet another hormonal method. If a woman has chosen not to use hormonal birth control, it’s her doctor who will try to change her mind. As we hear often, the decision is “between me and my doctor” and so, if the doctor is not present, I might choose to just stop of my own accord. I might even choose a contraceptive method very few doctors would recommend openly, like condoms plus withdrawal or a fertility awareness method.
If I had leg cramps at night, I might just stop using Yaz, rather than asking my doctor for advice and being told to keep taking it, because I’m not part of an at-risk group. I might save myself a visit to the hospital, or even my life.
If the Republicans are truly looking to throw Democrats into a tailspin and come out in favor of protecting women and women’s health, how about taking up the Christian Right’s preference of natural family planning? It’s not like the Christian Right isn’t swaying the party in so many other ways. Currently, the only form of birth control supported by the Catholic Church, the highly-effective NFP methods that involve tracking fertility cycles through basal body temperature, cervical fluid, and cervix position, have been gaining popularity amongst the non-religious of late, who are increasingly seeking non-artificial ways to control their fertility.
Campaigning for health insurance to cover classes, thermometers, speculums, books and follow-ups, instead of only problematic artificial birth control drugs and devices, seems like the next logical step. Republicans could even argue for the need for insurance to cover NaProTechnology, the Catholics’ favored protocol for treatment of PCOS, endometriosis, and infertility, which would surely counter the Democrat’s insistence that the Pill is a necessary and essential medication for women’s health.
Of course, this method wouldn’t make too much money for the pharmaceutical industry. But it would support women who cannot, do not, or will not use the drugs and devices currently available under the Affordable Care Act. Teaching women about their bodies, about how to know when you are and are not fertile, would have a positive impact of unwanted pregnancy rates and potentially lower the number of abortions conducted.
The Christian Right clearly has issues with the Pill, so the Republican Party should put its money where its mouth is and truly put an end to “birth control politics.” I’d be interested to see how the Democrats would respond to such an unexpected change of direction. Because, is this really about who cares more for women?
