The Pill — Lifestyle Drug or Medical Necessity?

Amanda Marcotte

On the right to contraception, pro-choicers have a slam dunk argument, right? But anti-choicers can chip away at contraceptive access without us noticing -- by redefining birth control as a luxury item, not a medical necessity.

recent video of John McCain unable to say that it’s unfair for insurance
companies to cover Viagra but not birth control left pro-choicers rejoicing.
  For a long time now, we’ve
been fighting to get the word out that right wing fanatics are hostile
to contraception, and now we have first rate evidence of a politician
pandering to anti-contraception forces.  Now the doubters will
have a lot less ground to work with. Now we’re that much closer
to exposing the agenda of the anti-choice  movement, which is not
just anti-abortion — but anti-contraception, anti-sex education, and

On this issue, pro-choicers
should have a slam dunk, right?  Ninety-eight percent of women will use contraception
at some point in their lives, and presumably most of the men who have partnered with women who use it support that right as well.  Most advocates
for any issue wish they had that kind of broad base of support. 
When people hear that such a popular right is under attack, surely they
will swarm as one voting bloc that gives new meaning to the phrase "vast
majority" to retaliate against a narrow band of extremists, right?
I’d like to think so.  Most of the time, I do think that we have
widespread support for the right to use contraception, support that
will eagerly fight to support that right under attack from a very small

But then I saw this video with
Bill O’Reilly defending McCain,

and I started to feel less sure of how firm the pro-choice ground is
on this issue.  O’Reilly doesn’t come right out and attack
the right to use the birth control pill.  But he does define it
as if it’s a luxury item, in fact putting it in the same category
as eating at a restaurant. (Women’s choice to have sexual intercourse,
according to O’Reilly, is a luxury, but for men, it’s a medical
necessity.  No, really.)  The double standard nauseates, but
the framing of the issue will win over a lot of people who think of
themselves as pro-choice on contraception.  The implication that
sluts have to pay for their own sinful behavior will resonate with a
lot of people, as will the idea that if you can’t afford the $30-$50
a month out of pocket for birth control pills, you don’t deserve to
have sex. 

The rule to remember with anti-choicers
is that they’re crazy but not stupid.  They know that openly
advocating for a ban on contraception won’t work, but they do believe,
with good reason, that they can chip away at the right to use contraception
slowly so that people don’t even see it coming.  After all, they’ve
had a lot of practice doing this to abortion rights, which also enjoy
the support of the majority.   

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Most people see that Roe v.
Wade hasn’t been overturned outright and feel secure with the right
to abortion.  Little do they know that the incremental chipping
away at abortion rights has, for a lot of women, meant that Roe doesn’t
exist in any practical way.  If you live far away from an abortion
clinic, or can’t afford an abortion, or have to go through waiting
periods and other forms of legal harassment, the amount of effort and
money you put into getting an abortion doesn’t differ from what you’d
have to put out if abortion was illegal.  For them, the difference
between legal and illegal abortion is a technicality on paper, not a
lived experience.  But with it being technically legal, most Americans
are complacent on the issue. 

Anti-choicers fully intend
to use the same strategy to chip away at your right to contraception,
getting rid of it in practical terms for many women while the rest of
us rest on our laurels, unaware of how much ground we’ve lost. We
know their methods, because of the abortion rights war.  Target
vulnerable populations first, people with little political power, such
as young women, women of color, and poor women.  Redefining hormonal
birth control not as a medication necessary for a healthy life, but
as a luxury that should only be available to those who can pay for it,
is a big step in targeting the young and poor. Age restrictions on
things like emergency contraception also play a role. Young women,
who are the least likely to have adequate experience using condoms (leading
to breakage), and are the most likely to be raped, have the greatest
need for emergency contraception, but if they’re under 18, they’re
out of luck, thanks to anti-choice tactics.  They’ll have to
get that abortion instead, in  many cases.  But they don’t
have much political power, so they need the rest of us to stand up for

Rural women and poor women
are the main targets of "conscience clauses," which aren’t about
religious freedom as advertised, but about restricting access to birth
control pills, one judgmental horror show of a fundamentalist Christian
pretending to be a professional pharmacist at a time.  For urban
women with a decent amount of money, going to the next pharmacist who’s
willing to do his damn job doesn’t take much effort.  But for
women living in isolated areas, or who don’t have the time or travel
range in the city because of poverty, being refused service in a pharmacy
could mean the difference between getting the pills and not.  

Unfortunately, I can easily
see a huge number of Americans who technically support the right to
contraception rolling over for the incremental strategy.  We are
indeed frogs sitting in pots of water on this issue.  Anti-choicers
aren’t going to turn the heat up to 10 right away, but will gradually
turn it up a little (deprive teenagers and poor women of their access
and then their rights) so that we don’t notice it, until it’s too
late and we’re all boiling in water.  But it doesn’t have to
be that way.  With pro-choicers out there spreading the word and
making the links between things like this John McCain video and the
crazies who are out to take away your birth control pills, maybe we
can turn down the heat. 

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