Sunday, December 09, 2007

Not Just a Price Increase: The Human Cost of Contraceptive Prices

After more than a decade of decreasing birth rates among teenagers, the birth rate among teenagers 15 to 19 in the United States rose for the first time since 1991, according to a recent report by the Centers for Disease Control. Births among teenagers tend to lead to poorer health outcomes for both the young mothers and their babies. Not surprisingly, the report further inflamed the already heated debate surrounding “abstinence only” versus “comprehensive” sex education and ignored crucial access issues. Sexually active women, especially young women, are at increasing risk for unintended pregnancy and unmarried pregnancy due to constricted access to effective contraception on a number of fronts. First, the increase in the number of states limiting teens’ access to confidential reproductive health services, legislating parental notification laws not only for abortion but also for contraception despite demonstrated reductions in teen pregnancy rates. Second, women’s and girls’ reproductive health is endangered by pharmacists’ refusals to fill legal prescriptions for emergency contraception and oral contraception, their refusals increasingly protected by so-called “conscience” legislation that sacrifices women’s and girls’ health to ideology. No lobby no presence. Third, the cost of contraception has increased beyond the means of college students. In July the Centers for Medicare and Medicaid issued regulations that remove the incentives for drug companies to provide deeply discounted prices to college health clinics; a one-month supply of oral contraceptives, formerly $3-$5 at college health clinics, now costs between $40 and $50 for name brands and $15 to $20 for generics. The price increase was widely expected to cause students to switch to less reliable forms of birth control (oral contraceptives are used by 39% of women in college according to the American College Health Association) or to cease using birth control due to lack knowledge about alternatives. Some college health clinics have tried to subsidize a portion of the price increases; others have ceased to offer oral contraceptives altogether.

We’ve lost sight of why we are having the sex education debate in the first place: because of its serious implications for women’s and girls’ health and well being. The ideal of access is not exhausted by having the best available information; we also need to assure the material conditions of making that information effective.

8 comments: said...

Spend your own money as those of us who support Pregnancy Assistance Centers and our local Abstinence Council do. Go teach at the schools for a day each semester.

However, if you read deeper - or take care of the young mothers as I do - you'll find that many of the girls get pregnant on purpose.

In Texas, the birth rates are skewed by our Hispanic population. The tradition leads the girls to believe that they are grown at 15. La Quinceanera is something to experience - reminds me of a wedding, with white gown, atendants, the Mass at Church, the reception, with the addition of a crown.

More, when a girl becomes a mother, she is given special status as an adult by her tradition.

Anonymous said...

I don't think that you used nearly enough "scare quotes" in this "post."

In the case of pharmacists, you're ignoring the existence of pharmacists who think that women, especially teenage girls, are poorly served by handing them a pack of pills and telling them to have at it.

You are referring to the "health" of women as something that can be protected with contraceptives as if sex were not a voluntary act and is something that just happens to women.

Kelly Hills said...

Hmm. Is using "scare quotes" three times - once each for "abstinence only", "comprehensive" and "conscience" really excessive? If Robin was really trying to make some snide and subtle or subliminal point against any particular sort of belief on sex education (and why would she need to, when most of us are pretty open on our strong support for access and education?), why in the world would she be "inconsistent" and include "comprehensive" in scare quotes?

Just sayin', the logic ain't working for me.

Anyhow, Robin - being on a college campus since our formulary changed its coverage has been a sadly eye-opening experience. Many of the girls, as has been reported at college campuses across the country, can't afford the pill any more, and are making dumb choices about birth control.

Of course, the saddest cases - and ones often lost in the kerfluffle over rises in cost and loss of access - are the ones where someone is using the pill for non-pregnancy preventing medical reasons, and finds themselves priced out of the medicine they need.

Anonymous said...

"... as if sex were not a voluntary act and is something that just happens to women."

Would anybody want to sentence a child to a precarious existence? Coming into this world is a lot easier if you're wanted.
Viva la contraception.
Thanks for writing about this policy change. I had not heard about it.

SabrinaW said...

you'll find that many of the girls get pregnant on purpose.

I don't see what this has to do with policies that reduce accessibility of contraception. There are many women who do not wish to become pregnant, and many women who suffer health conditions that are remedied by hormonal contraception, and sitting back to let women be punished while men are given a blank check to be irresponsible is immoral.

LB said...

I thought of this post here when I saw this blog post this afternoon.

SabrinaW said...

That's an interesting idea, and while it presents some food for thought regarding societal standards, there is still a moral statement being made by removing access to contraception. Pair that with draconian economic conditions and no support for children who are already born, and it's a pretty sad statement in a nation that supposedly enacts policies to preserve human life.

LB said...

Draconian? Really?