Politics of Long-Term Birth Control

By Kristen Barton

In 2016, some women were deciding who to vote for. Texas Tech student Gaby Wohead was worrying about how the presidential election would affect her affordable access to birth control.

As the election inched closer and Wohead saw the chance that Donald Trump would become president, she decided to make sure her reproductive health was under her control. After hearing President Trump’s proposed health care plan, she was afraid that her current method of contraception — birth control pills — might not be affordable for her in the future.

She started looking at other options and in September, the senior human development family studies major decided on an intrauterine device (IUD).

“I was kind of scared that one day I won’t be able to get birth control, so I thought I should get this thing now, for five years, and won’t have to worry about it,” she said.

How it Works

According to Planned Parenthood’s website, the IUD is inserted in the uterus and prevents sperm from reaching the eggs by deflecting sperm.

There are hormonal and non-hormonal IUDs. The hormonal devices thicken cervical mucus, blocking and trapping sperm and sometimes stop the egg from leaving the ovary, preventing ovulation. The non-hormonal IUDs use copper, which sperm avoids.

Ammar Dhari, M.D., faculty physician for Texas Tech OB-GYN, said he loves the IUD as a contraceptive method. It is a LARC, Long Acting Reversible Contraceptive method.

“We include it almost always in our counseling about birth control for the patients,” he said. “I would say like 20 or 25 percent of our patient population go on it and use it.”

The pregnancy rates are low on the IUD, Dhari said. According to Planned Parenthood, they on of the “best birth control methods” and are more than 99 percent effective in prevention of pregnancy. IUDs do not protect against sexually transmitted diseases, so Planned Parenthood recommends using condoms along with an IUD.

The hormonal IUDs can also treat irregular periods or stop menstrual bleeding altogether, Dhari said. An IUD can also treat precursors of and stage one endometrial cancer.

Pros and Cons

Wohead said she is not the type of person to have a set routine, so remembering to take a pill at the same time each day was not ideal.

“I’d rather just have something that I know is going to work regardless,” she said. “I don’t have to be that responsible with it honestly, it’s just there and it’s going to protect me.”

Samantha Steelman, a senior from Lubbock, agreed that taking the birth control pill required too much diligence.

At random points in her day, Steelman was asking herself if she remembered her pill, causing stress for her.

“User error seriously lowers a birth control method’s effectiveness and that was a lot of stress for me,” she said. “An IUD seemed like the perfect, no-maintenance, no user error option.”

Steelman had her IUD inserted in April, since she will no longer be on her parent’s insurance plan in two years and wanted a long-term form of birth control.

While the IUD is low-maintenance and long-lasting, there are still potential disadvantages.

Photo by Kristen Barton.

“Sometimes there could be pain with insertion during these procedures, the cramping I think can sometimes go on for a couple weeks, irregularities in the period the first few months or several weeks of insertion until it settles in,” Dhari said.

He also said there can be more rare complications where the IUD can fall out of the body, the body can reject it, or a heavy period could cause it to be flushed away. He also said it could become embedded in the wall of the uterus and also it could migrate into the patient’s abdomen and it will require surgical intervention to remove it.

IUDs in a Trump Administration

According to TIME, the Better Care Reconciliation Act defunds Planned Parenthood for at least one year, which gives millions of low income people birth control. The legislation also allows states to redefine what qualifies as an Essential Health Benefit under Medicaid, so states could decide to not cover birth control under Medicaid anymore.

Both Wohead and Steelman started exploring long-term birth control options because of fear of restrictions by bills like this and any in the future that may affect women’s healthcare.

IUDs can last up to 12 years, so it is possible for the birth control method to outlast the current administration.

The TIME articles states that defunding Planned Parenthood could make hundreds of thousands lose access to health care. This could help explain why Planned Parenthood saw a “tenfold” increase of women seeking IUDs shortly after the election of President Trump.

“It will cut off a lot of people from access to insurance and then in turn birth control, which in turn can be a backfire burden on pretty much all of us because unintended pregnancies are 51 percent of [all pregnancies],” Dhari said. “This will probably increase with access to lack of birth control.”

Dhari said this is something doctors are considering and prepared to tackle on the horizon. If someone plans on not getting pregnant in the next three to five years, he strongly suggests using some type of LARC, like the IUD.

Without insurance coverage, IUDs can be costly. Dhari said the device itself could cost between $200 and $400, the insertion fee could be between $900 and $1,400, depending where the procedure is performed.

 

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