Wielding Power on World Contraception Day | Opinion

Sunday was World Contraception Day, an annual celebration to improve awareness of birth control and enable individuals to make informed choices about their sexual and reproductive health.

During a standard year, it’s a time to reflect on the transformative impact of birth control. But this year – after the Missouri legislature risked destabilizing the entire state budget to eliminate IUDs and emergency contraception from the state Medicaid program – it’s something else entirely: a cautionary tale.

Recent headlines have been dominated by the vigilante justice-spiked abortion ban enacted in Texas. Almost immediately, legislators across the nation vowed to do the same, including here in Missouri.

“We’ll make it not just difficult, but unthinkable,” they said as they finished their fundraising letters and jockeyed their way to higher political office. But the reality is that access to reproductive healthcare, including abortion, is already very limited – unthinkable even – for many rural, young, and Missourians of color who face disproportionate barriers to healthcare. While Medicaid expansion creates a pathway to coverage for 275,000 additional people in need of care, significant health inequities persist, deeply affecting the state’s most marginalized.

Fortunately, there are two high-quality contraceptive equity programs operating in Missouri, run by Missouri Family Health Council. Between the Title X federal family planning program and The Right Time, an initiative of Missouri Foundation for Health, over 85 clinic sites throughout the state offer low or no-cost birth control and other sexual health services, also through telehealth. These programs don’t just offer high-quality healthcare, they empower people to take control of their health and pursue the future they want, including if, when, and under what circumstances to become pregnant.

The family planning safety net, however, remains imminently at risk. Just this week, the Senate Interim Committee on Medicaid Accountability and Taxpayer Protection rubber-stamped recommendations to supercharge provider requirements, exclusively aimed at eliminating Planned Parenthood from the state Medicaid program.

That’s a dangerous play when the need for publicly-funded family planning services already outweighs the capacity of the current system. These patients cannot simply be absorbed by other providers – not during a continued global health crisis and not ever. Instead, strain on providers will intensify and patients will experience longer wait times, be forced to see a provider they don’t choose, or forego care altogether. For public health, that means increased transmission of sexually transmitted infections and more unintended pregnancy.

The safety net needs providers with same-day availability, the full range of contraception, and culturally competent, trauma-informed care. This is especially important for immigrants, the LGBTQ community, survivors of domestic violence or sexual assault, and those who suffer from abuse or coercion in intimate partnerships – all already facing barriers navigating the health system and finding care they know and trust.

Access to birth control isn’t a luxury, it’s an imperative. Aside from empowering people to take control of their health and lead self-determined lives, contraception allows people to plan and space their births, leading to improved outcomes for women, families, and society as a whole. The average U.S. woman uses contraception for thirty years in order to have only two children. That’s three decades preventing pregnancy.

There are ancillary benefits to contraception as well, including treatment for painful periods, endometriosis, and acne. As said by Republican state Sen. Jeannie Riddle during the debacle over the state federal reimbursement allowance, “women in the state of Missouri want, need and deserve contraceptives.”

There are policy solutions to increase access to contraception in Missouri, including providing annual-supply birth control, allowing pharmacist-dispensing of birth control, making birth control available over-the-counter, and making emergency contraception immediately available to survivors of sexual assault. If only the Missouri legislature’s passion for freedom extended beyond COVID-19.

What we learned from the FRA fiasco was that using birth control as a bargaining chip is not a winning strategy. It also affirmed that reasonable minds do not differ when it comes to a healthcare service 99% of people of childbearing age use at some point in their reproductive lives. Birth control is not negotiable. On this World Contraception Day, we wield its power.