For decades now, advocates for religious and reproductive rights have argued their morality on the grounds of women’s health. The latest crusade comes with Trump’s announcement to expand religious accommodations and overturn the contraceptive mandate under the Affordable Care Act. Effective immediately, the federal rules allow employers, and now universities, to deny women contraceptive coverage based on, “sincerely held religious beliefs.”
A feminist and the daughter of a long-time Planned Parenthood employee, I too am guilty of proselytizing family planning. My experience, both as a health educator and as a Reproductive Justice Intern at the American Civil Liberties Union this summer, has re-enforced my belief that the ability to control one’s fertility is, indeed, a fundamental human right.
But, as a student of public health, I must ask: should we be using belief to create policy for a service that nine out of ten women will use in their lifetime? Are moral objections to people’s private lives what will dictate the future of our next generation? When we spend our time arguing over individual rights, we nullify the evidence that supports contraception and silence those who stand to lose.
Rather than focusing on what we believe, reproductive justice advocates should instead turn to what we know.
The fact is, it is far safer to have an abortion in this country than it is to give birth to a child, and safer still to prevent an unintended pregnancy from happening in the first place. More women in the U.S. die of pregnancy-related complications than any other industrialized country and this gap is even more extreme for adolescents. Sadly, the U.S. also holds first place among these nations for our teen pregnancy rates—a position President Trump all but guaranteed with his cuts to the Teen Pregnancy Prevention Program. By limiting access to education and contraception, the administration condemns a generation of young people to unintended and high-risk pregnancies. Women’s lives appear an acceptable trade for clean corporate conscience.
Women’s experience preventing pregnancy is also powerful evidence. I have worked with countless young people for whom negotiating sex was not always an option and supporting a child was not economically feasible. At one point in my life I would have considered myself among them. Yet, contrary to the administration’s claim that the exemptions won’t impact those most “at risk,” unintended pregnancy does not discriminate. I have no qualms sharing that I would not be where I am today without access to free contraception. I confidentially received birth control on my parent’s health insurance plan throughout high school and college. It is one of the reasons I now work in reproductive health to expand access for adolescents.
Since its inception, the contraceptive mandate has been hotly contested. President Obama added birth control to the list of preventive services covered under the ACA at the urging of women’s health specialists, not on the basis of his beliefs. But, as another week under the Trump administration has shown, those in political power will ensure their morals prevail—no matter the cost.
I trust legal advocates to argue the case for contraceptive coverage in court. However, if we have learned anything, it’s that we will be playing defense for women’s health for the foreseeable future. It’s time for the public health community to step out from behind our scientific empiricism and into the political arena. Together we can lobby our representatives with our research, add our evidence to public comment, and bolster legal arguments with personal narrative. We must also find our own “workarounds” to the rules, by supporting efforts for over-the-counter birth control, expanded availability of medication abortion, and legislation for state-funded family planning programs. Maintaining access to care for the most vulnerable among us should be our guiding light—join us.