We Talked To An Ob-Gyn About Your Birth Control Options Under Trump

Should you get an IUD immediately? What happens if ACA is repealed? What if you can't afford your co-pay? 

The average womanwill spend more than three-quarters of her reproductive life trying to avoid an unintended pregnancy. In fact, 99 percent of women between the ages of 15 and 44 who are sexually active have used birth control at some point, so if you’re freaked out about The Trump Administration’s kamikaze destruction of reproductive rights and the possible repeal of the Affordable Care Act, know that you are not alone.

Demand for IUDs has gone up 900 percent since Trump’s inauguration, ostensibly out of fear that access to birth control may go away entirely, thus the instinct to lock down a birth control that will outlast Trump reign in the oval office (IUDs are a long term form of birth control that last up to 12 years). Call me a social justice warrior, but this little snowflake is still a fan of facts and expert opinions, so I sat down with OB/GYN and “lasso of truth wielder” extraodinare Dr. Jen Gunter to get the skinny on what will happen if Trump really does grab America by the p*ssy. First thing’s first:

Are We Going To Lose Access To Birth Control Entirely?

Short answer, no. There are a number of threats to being able to access birth control, but the reality of it is, as long as you have a little bit of money and the ability to travel, some form of birth control will always be available. 

The two big threats to birth control are affordability and accessibility. Under the ACA, birth control is offered to patients without a co-pay, which is especially important with long term birth control such as an IUD, which has a higher up-front cost. Without the ACA, employers may choose not to cover any form of birth control if they maintain a “religious objection” to the practice, which puts women on the hook to pay for it out of pocket, even if other prescriptions are covered. Dr. Gunter explains, “I think it is the idea that women could end up paying more for healthcare than men of the same age, that being a woman is somehow a burden or requires a tariff. That is such an awful message.”

This is especially tragic since birth control controls medical uses outside of pregnancy, such as infections in the ovaries, fallopian tubes, and uterus, endometrial and ovarian cancers and anemia. 

What About Long-Term Birth Control, Such As IUDs?

The national median cost of an IUD without health insurance is $1,111, and there is a chance that they may disappear entirely. According to Dr. Gunter: “While the Supreme Court has ruled (In the Hobby Lobby case) that if a religious group sincerely believes IUDs are abortifacients" - meaning that they cause abortions - "then that is good enough. That is still a long way from making IUDs illegal. That being said, the people Trump has aligned himself with, the Susan B. Anthony List and others, have made no secret of their desire to do away with IUDs.”

Should I Rush Out And Get An IUD Immediately?

Not unless you want to! If you signed up for health insurance during open enrollment (which ended January 31st of this year) those contracts will honored until the end of the calendar year, so no matter what happens, you have time. I’s important to decide whether or not a long term birth control is right for you. Take it away, Dr. Gunter!: “I think there are valid concerns about contraception coverage down the road, but I don't think a woman should choose a long-acting birth control method out of fear. IUDs have the highest user satisfaction rate and the lowest failure rate, so there are plenty of reason to choose them. Choosing an IUD or the Implant if you are not sure it's right for you could lead to regret, and we don't know if removal would be covered or not down the road the expense on the back end.”

What Happens If The ACA Is Repealed?

The Affordable Care Act requires health insurers to cover all approved forms of birth control without charging women any co-payments. If that changes, or if the ACA is repealed, women will face an average payment of $15-50 per month for the birth control of their choice, depending on their insurance and type of pill. Tens of millions of women currently have access to no-cost contraception under the Affordable Care Act, and 32 million Americans could lose their insurance if ObamaCare is repealed. If ObamaCare is repealed, as many as 18 million Americans will lose health insurance by the end of 2018, and around 32 million in total will go uninsured by the end of 2026.  

What If I Can’t Afford My Co-Pay?

If that happens, you should immediately send a postcard to Tom Price, Trump's nominee for secretary of health and human services, letting him know he is wrong. In a nation with a 51 percent unintended pregnancy rate, the highest in the industrialized world, with the heaviest concentration of unintended pregnancies coming from poor women, Tom Price claims not a single woman in the United States has never struggled to pay for her birth control. Bullshit. If you find yourself in a pinch, Planned Parenthood is generally a good bet, but it may involve a significant commute depending on where you live. Dr. Gunter recalls, “When I worked in Kansas City at the HeaIth Department in their family planning clinic, I remembered a woman telling me she took two buses to see me, and that always stuck with me. Many women go to great lengths to get affordable contraception.”

In addition, don’t be afraid to go generic if you find yourself facing a prohibitively high co-pay. “brand names don't really offer anything special or unique. It's all marketing, so I wouldn't tell anyone to get caught up in a brand. I would look at the ingredients and for a generic with the same hormones and dosing. Many generic pills are quite inexpensive,” says Dr. Gunter.

Parting Shots

In the land of health care, birth control has an incredibly high return on investment. Women with access to safe and reliable birth control are less likely to become pregnant (obvi) which saves health care companies beaucoup bucks on prenatal care and childbirth, both of which come with a substantial cost. Trump himself said in a 2016 interview with Dr. Oz  that he believes birth control should “should not be done by prescription,” because politics aside, birth control makes a lot of sense. The moral of the story is don’t be scared, but do be prepared. 

You can find more from Dr. Jen Gunter at www.DrJenGunter.com and follow her on Twitter @DrJenGunter. 

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