My patient Michelle, age 25 and newly married, has a severe congenital heart disease. Pregnancy would be life-threatening; Michelle has a 50% chance of dying if she carries a baby to term. She isn’t willing to take that risk.
Condoms are effective only 85% of the time, and the pill isn’t safe with her heart condition. Together we agreed that the IUD would be best, an extremely safe and effective method that costs $800. Michelle was able to afford it only because her job’s insurance paid for it in full.
If she worked for one of the institutions now in court over contraception coverage, Michelle would be suffering financially or gambling with her life—all in the name of someone else’s religious freedom.—Sara Pentlicky, MD, Philadelphia
Raquel, age 23 and mother to a seven-year-old son, had never been able to afford long-acting, effective contraception. In her subsequent unintended pregnancy, she was hospitalized with pulmonary hypertension, or high blood pressure in the lungs, a life-threatening condition in pregnancy. After four months in the hospital, Raquel gave birth to a girl. Twenty-four hours later, she died, her son crying by her side. She left behind two kids and a compelling message about the need for contraceptive coverage. Lack of coverage can have tragic consequences. I will never forget Raquel and her family. —Jennifer Kerns, MD, San Francisco
Sandy worked at a Catholic hospital in Baltimore. She came to me seeking help for her heavy, long periods. Oral contraceptives would have altered her quality of life dramatically, but because her insurance would not cover birth control, she couldn’t fill the prescription. Sandy’s health insurance should have covered all of her health care needs. —Zowie Barnes, MD, Baltimore
As an obstetrician/gynecologist, I have many patients like Jennifer, a 22-year-old Catholic mother of one. She has decided to postpone expanding her family while she works and finishes school. For birth control, she selected an IUD, a long-acting, extremely effective method. Her job’s insurance took care of the cost.
But if Jennifer worked for an institution that refused to cover contraception, she might not be able to afford the device or strain her family finances to afford it. Or she would be forced to set aside the IUD she knows would be best for her and use cheaper, less effective birth control, increasing her risk of an unintended pregnancy. With health reform’s contraceptive coverage, more women will finally have access to affordable contraception.—Kathleen Morrell, MD, Brooklyn
My patient Cathy, now in her 30s, was a teen mother. Recently she brought her two daughters, both in their teens, to see me for contraception. The young women each received an IUD, a highly effective contraceptive that the family wouldn’t have been able to afford out of pocket. Cathy offered her daughters an opportunity she didn’t have: a chance to finish school and decide when and if to become parents. She gave them the gift of self-determination.
As we celebrate such signs of progress, we must remember that many women still lack access to affordable birth control options—for themselves and their daughters. Read More