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Improving essential contraception access in Maine

By Lydia Townsend (she/her) University of Maine Women’s, Gender, and Sexuality Studies student and Mabel Wadsworth Center intern

 

Ensuring that all people have access to contraceptives is crucial in supporting reproductive autonomy. Providing individuals with contraceptives that best suit their needs allows them to be in control of their future – deciding when and if they wish to be pregnant. Not only does access to contraception provide autonomy, but it is also key to the health and safety of all individuals involved. Contraceptives are important tools in preventing unintended pregnancies and, in the case of barrier methods like condoms, sexually transmitted infections (STIs). 

Contraceptives come in many forms, ranging from barrier methods, to pills, to injections, to intrauterine devices (IUDs). This variety in forms is necessary and essential, as each person’s needs differ, and some contraceptives may be better suited for them than others. Condoms and dental dams, for instance, reduce the transmission and spread of STIs, and condoms can be utilized for penetrative sex. The hormonal contraceptive injection, Depo-Provera, can be especially important for individuals who are experiencing reproductive coercion. It is a form of contraception that cannot be removed or as easily withheld by an abusive partner or parent. IUDs are beneficial for individuals who do not want to have to remember to take a pill each day and/or who want a form of birth control that lasts numerous years. Birth control pills are a good option for those who may not want to be on birth control for an extended period of time or will easily remember to take a daily pill. Additionally, both IUDs and pills come in varying ratios of hormones, some even without hormones, providing an option to individuals who may be more sensitive to hormonal changes. While some people don’t tolerate hormonal contraception well, others may see benefits ranging from reduced acne to improved mood.

Just recently, the FDA approved the first ever over-the-counter hormonal birth control option in the US, known as the Opill. This is a progestin-only oral contraceptive that will now be accessible without a prescription, a crucial step in ensuring reproductive autonomy. Over the counter oral contraceptives are already accessible in over 100 countries, the United States is just now following suit. Not only will the Opill be available at local pharmacies, but also for purchase online, which helps to eliminate access barriers. 

The approval of the Opill helped to inspire a bill (LD2203) here in Maine, a bill that would expand access to contraceptives for all. The bill, put forth by Representative Poppy Arford, specifically calls for health insurance companies to cover the cost of over-the-counter contraception, including condoms, emergency contraception, and the newly approved Opill. In providing these options to individuals, without having to pay out of pocket or receive a prescription, reproductive autonomy is being protected. This bill would help to ensure that Mainers have access to over-the-counter contraceptives, helping to eliminate potential financial barriers. 

This bill is particularly important for marginalized people who want contraception but face barriers in access. These barriers are compounded by factors such as socioeconomic status, race, ethnicity, and gender and sexual identity. Through expanding coverage to these additional forms of contraception, individuals will now be able to access the contraception they wish to without having to worry about issues such as cost. Additionally, this bill is important to Mainers as we currently face a healthcare shortage here in the state. In recent times, it has become extremely difficult to find a provider who does not have a month(s)-long wait list, let alone one who is actually accepting new patients. In specifically expanding coverage to include the Opill, individuals who desire to be on the birth control pill are able to do so without having to wait months to be given a prescription. As we also know, Maine is a relatively rural state and therefore without a car or method of transportation, accessing a healthcare provider can prove to be a difficult task. The framework of this bill helps remove these potential barriers, allowing people to access an oral contraceptive at their nearest pharmacy. In having insurance cover the costs of these contraception options, autonomy will be given to individuals, allowing them to make decisions regarding their own reproductive health.