Commentary Law and Policy

Celebrate, then Advocate Some More: How to Meet the Demand for Contraceptives After August 1st

Sara Alcid

Now that we’ve had a month to celebrate the triumph of No Copay Day, it is important to look forward and carefully consider what comes next on the advocacy agenda for effective implementation of the ACA’s reproductive health measures.  

Exactly one month ago, I celebrated No Copay Day by making birth control-themed cupcakes.  I consider myself to be rather domestically disabled, so the world knows something important is happening when I bake.  

The Affordable Care Act’s (ACA) provision of no-copay contraception is certainly an important turn for the status of women’s reproductive health in the United States.  Until August 1st of this year, women were legally charged higher insurance premiums just because of their gender.  In other words, our “femaleness” was legally considered a liability.  Pass the cupcakes, I say.

Now that we’ve had a month to celebrate the triumph of No Copay Day, it is important to look forward and carefully consider what comes next on the advocacy agenda for effective implementation of the ACA’s reproductive health measures.  

Financial access to women’s preventive health care is only half the struggle for women with limited resources. Now most women have this piece taken care of, but the other part of the struggle lies in convenient physical access. Recent research reminds us that physical access may continue to be a barrier to reproductive health care services, even when women have financial access.

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Picture a student attending college in a rural area of Idaho that can now obtain birth control pills without a copay. Her campus health center provides the prescription, but with the nearest pharmacy fifteen miles away and without a car of her own, she has to rely on the college ride board to be able to obtain her birth control.

Or picture a working mother using oral contraception to prevent future pregnancies. She realizes on a Sunday evening that she forgot to take her birth control pills for the past few days, during which she had intercourse with her partner. She knows the emergency contraception ella® is covered under the Affordable Care Act, but she can’t afford to take time off from work during the next few days to obtain a prescription and go to the pharmacy.

These are just two illustrations of how financial access doesn’t necessarily ensure that women will not experience detrimental gaps in their contraceptive coverage.

The current shortage of health care providers is another issue that will impede women’s access to contraception. Apart from making sure there are enough providers and incentives to encourage them to work in under-served areas, we should also push ourselves to think about how we can bring innovation to traditional service delivery that would enable providers to reach more women and overcome access barriers like distance, time and language. How can we meet the demand for contraception in ways that do not rely on a typical patient-provider relationship that seems to no longer be compatible with women’s lives and schedules?


Photo credit: Daily Trojan.

When it comes to reproductive health and contraceptive services, more creative and boundary-breaking thinking is needed to make sure that women have real access to the contraceptive technologies they use to protect their health and achieve their reproductive goals.

The possibilities for innovation in service delivery are endless and we’ve started to see some coming to life. What sort of delivery mechanism could enhance that college student’s ability to obtain birth control? 

What about an online pharmacy that specializes in contraception and could ship birth control overnight? This model already exists in Europe and even facilitates online consultations with doctors so that women can access contraceptives without a pelvic exam, which health experts have deemed unnecessary for most women on an annual basis.

In the United States, Conscious Contraceptives is an online store that ships condoms and other safe sex supplies discreetly and directly to consumers. And a feel-good bonus is that a portion of every purchase helps bring contraceptive supplies and information to under-served communities both at home and abroad.  

Conscious Contraceptives does not currently offer hormonal contraception, but wouldn’t it be fantastic if they could sell and ship Plan B, ella and other hormonal contraception to women across the nation without a prescription

Here at the Reproductive Health Technologies Project, we’re exploring the concept of a Sunglasses Hut for contraception.   A one-stop shop for women’s contraceptive questions and needs—the Happy Health Hut.  

The technological infrastructure is in place for innovative service delivery, but the grassroots and political will to experiment and implement successful models has less momentum.

Think about your own experience in obtaining contraception. What challenges have you faced in obtaining your birth control? And what means of service delivery would have lessened this barrier? Would you like your partner to be able to be more involved in helping you obtain contraception? Be creative! 

Personally, I would like to see a contraceptive spin on fast food restaurants. A chain of fast contraception drive-throughs. Condoms, dental dams, and lube would be on the dollar menu and a 6-month supply of oral contraception would be the Big Mac of birth control.

Now it’s your turn to brainstorm! Share your ideas for innovative contraceptive service delivery in the comments. Let’s get the conversation about innovative service delivery started, right here.

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