By Savanah McDaniel
Over the last few months, the Trump Administration has blatantly violated women’s right to healthcare. In April, President Trump signed an executive order cutting government funding for Planned Parenthood. Last month, the Administration reduced healthcare access for women by rolling back an ACA mandate that required employers to cover birth control costs. Now women’s access to birth control depends on their employer’s moral or religious stance, while clinics that provide contraceptive assistance have been defunded.
Under attack by religious conservatives, women’s access to healthcare relies increasingly on science for support. Studies across disciplines have concluded that access to birth control improves the health of women and their children, and allows women to obtain higher paying jobs[1]. Even with bodies of research supporting women’s access to birth control, there is still a movement to remove this necessity. Political discourse often ignores the data, presenting birth control as a controversial, moral issue. Though if the decision to cover birth control was a strictly ethical one, politicians and the religious right would stop denying science and support contraception. Sadly, moralistic arguments do exist- even in medicine.
Earlier this month, Marguerite Duane, M.D. published an article titled “Stop Denying Science. Birth Control Isn’t Necessary for Women’s Health.” In her article Dr. Duane uses personal anecdotes, biased with her moral-political convictions, in lieu of scientific evidence to support the Trump Administration’s roll back. Since Dr. Duane is using her position as a medical expert to support recent political rhetoric that limits women’s healthcare options, I find it important to deconstruct her argument using data from peer-reviewed articles, widely accepted by research-backed organizations and medical associations[2].
“birth control is not the only, or even best, way to treat the reproductive issues women experience.”
Here, Dr. Duane introduces the adverse side-effects of birth control she experienced, to support her claim that birth control is not necessary to women’s health. I agree that the pill or other hormone-based contraceptives are not the only way to treat issues like menstrual irregularity and pain, however, these treatments are effective for many women. In fact, 58% of women in the US who take the pill do so for non-contraceptive reasons[3]. Hormonal birth control- like any medication- can produce adverse side-effects. Unless the medication is causing more harm than benefit, side effects should not necessitate market removal. A logical solution to this issue would be to promote better research. More research on women’s reproductive health could lead to birth control and other treatment methods that do not have as many side-effects.
“While it can help prevent pregnancy and then only some of the time, it does so by suppressing the normal function of a woman’s reproductive system” [italics added]
Contrary to the first part of this statement, the most common contraceptive methods (male condoms, IUDs, the implant, and the pill) are above 90%[4] effective at preventing pregnancy[5]. Whereas the family planning, or “charting”, methods Duane advocates for are only 76% effective[6]. Though some of these more effective methods come with side-effects, as Dr. Duane points out in her article, most women consider effectiveness a top priority when considering contraceptive options[7]. Among women in the US who currently use contraception (which is 62% of 15- 44 year olds) the most common contraceptive methods are the pill, male condoms, IUDs, Implant, and female sterilization[8]. Even though fertility-based “charting” methods do not produce side-effects, they are less effective and therefore less popular among women.
Like her claim to the effectiveness of birth control, the second part of this statement is also arguable. By stating that birth control suppresses the normal function of a woman’s reproductive system, we can infer that Dr. Duane also means natural– or unimpeded by medical treatment. My inference here is supported by her statement that birth control should not be used to treat noncontraceptive issues like cramps because it “suppresses” a woman’s fertility[9]. There are many reasons why women take hormone-based contraceptives, including regulating their period. Should women with an irregular, or a naturally suppressed menstrual cycle, not take the pill? By this logic any chronic disorder, which occurs naturally -like the author’s asthma- should not be treated because it disrupts the body’s “normal function”. Furthermore, there are hormonal disorders like polycystic ovary syndrome (PCOS) where birth control is a major treatment method. Whether it be an inhaler or birth control, medical interventions are necessary because bodies can disfunction, naturally. A person with asthma needs access to an inhaler, just as someone with PCOS needs access to birth control.
“Why do we ‘fight for birth control’ but not drugs that allow people to breathe?”
First, this is not an issue of insurance either covering birth control or other medications; removing birth control coverage does not preclude taking access away from other medications. Any medication that treats issues which impede a person’s life should be accessible. Private insurance companies are not struggling; there is funding to cover birth control as well as other necessary medications. Additionally, comparing access to asthma medication to that of birth control is like saying, in the words of Irina Dunn, “a woman without a man is like a fish without a bicycle”: the two do not relate. 1 in 12 people in the US suffer from asthma[10] whereas 99% of women will access birth control at some point in their lives[11]. Not only does the funding of birth control not affect access to asthma medication, removing access to birth control will directly affect more people than there are asthmatics.
Second, we (feminists, women’s rights activists, concerned human beings) fight for birth control because all women deserve to lead healthy lives, unimpeded by unplanned pregnancy and reproductive issues. Through protests, collaboration, and lobbying we have and will continue to defend access to this necessity. The argument that Dr. Duane presents uses personal anecdotes, masquerading as scientific evidence, to defend the Trump Administration’s repeal of the ACA mandate. In supporting a company’s decision to deny coverage of birth control for moral or religious reasons, she ignores research that shows birth control increases a woman’s quality of life by opening up employment opportunities, decreasing unplanned pregnancies, and treating painful reproductive disorders.
It is irresponsible for Dr. Duane to use her medical authority to support an opinion- not science- that threatens women’s rights. In advocating to defund birth control coverage, and rejecting medical literature that supports birth control access, Dr. Duane invalidates her medical expertise. Unsurprisingly, though her argument contradicts the data, it does align with her pro-life views and fertility-oriented organization. Duane co-founded the Fertility Appreciation Collaborative to Teach the Science (FACTS), which values women for their reproductive capacity, erasing the complexity of women’s lifestyle choices and contributions outside of child rearing. Her conservative, pseudo-scientific argument threatens to reduce women to reproductive vessels, while supporting the strategic removal of women’s rights through Trump’s policies. These political moves are unacceptable, blatant, sexist rhetoric that endanger women’s health and humanity. Through her writing and political organizing, Duane is not only complicit, she is actively supporting the dehumanization of women. We must not allow anyone, especially those who masquerade as public servants, to limit our contributions to society, to reduce our value to our bodies- nay our wombs. So yes, in the words of (Dr.) Marguerite Duane, “stop denying science”.
Editor’s Note: Many people who use and depend on birth control do not identify as “women,” and their access to healthcare is arguably even more threatened by the Trump administration’s agenda. Despite its terminology, this article is not intended to essentialize “women’s health” into an exclusive category.
[1] Adam Sonfield, et al. “The Social and Economic Benefits of Women’s Ability to Determine Whether and When to Have Children,” (New York: Guttmacher Institute, 2013), 14-18, <http://www.guttmacher.org/pubs/>.
[2] All data was collected from articles published in peer-reviewed journals or by organizations using data published by similar sources such as the Center for Disease Control and National Institutes of Health.
[3] Rachel K. Jones. “Beyond Birth Control: The Overlooked Benefits Of Oral Contraceptive Pills,” (New York: Guttmacher Institute, 2011).
[4] The pill and male condoms are 99% and 98% effective with perfect use, 91% and 82% with typical use.
[5] Center for Disease Control and Prevention. “Effectiveness of Family Planning Methods,” (2011), <https://www.cdc.gov/reproductivehealth/unintendedpregnancy/pdf/contraceptive_methods_508.pdf>
[6] Ibid.
[7] Cassondra Marshall, et al. “Young Women’s Contraceptive Decision Making: Do Preferences for Contraceptive Attributes Align with Method Choice?” Perspectives on Sexual and Reproductive Health 48, no. 3 (2016): 119-127.
[8] Kimberly Daniels, et al. “Current Contraceptive Status Among Women Aged 15–44: United States, 2011–2013,” National Center for Health Statistics, no. 173, (2014).
[9] Fertility Appreciation Collaborative to Teach the Science. “About FACTS: Statement of Principles,” (2017), <http://www.factsaboutfertility.org/about/>.
[10] Center for Disease Control and Prevention. “Asthma in the US,” (2011), <https://www.cdc.gov/vitalsigns/asthma/index.html>.
[11] Adam Sonfield, et al. “The Social and Economic Benefits of Women’s Ability To Determine Whether and When to Have Children,” (New York: Guttmacher Institute, 2013), 3, <http://www.guttmacher.org/pubs/>.