How The Birth Control Rules Are Affecting CT Women

STORRS– The brisk air nipping at their ears, bundled jackets making it hard to move their little limbs and physical education teachers shouting and blowing their whistles: the timed mile run is an American rite of passage.

But for 9-year-old Lily Zappulla, there was something atypical about her experience. She got her first period in gym class that day.

Embarrassed and afraid, she approached her male gym teacher to let him know she was sick and had to go to the nurse’s office. She ran to her mother who was the school librarian at the time, and she gave Zappulla a pad to wear for the school day.

“I bled through it in about an hour, and I didn’t know it was abnormal, so I sat on my black coat to absorb it until I got home,” she recalled. “It was truly traumatic.”

“It’s hard for me to even articulate how grateful I am for my little blue pill I take each morning,” says Zappulla, 12 years later. “It saved my childhood and adolescent years from agony and embarrassment.”

For some women, birth control is a medical necessity. For Zappulla, her monthly pill would cost her $50 a month without the help of her health insurance provider. Despite stories like hers, the administration of Donald J. Trump stipulated on October 13, 2017 that employers who cited religious or moral objections could opt out of covering birth control pills in their health insurance plans.

According to Patricia Moriarty, nurse practitioner at UConn’s Student Health Services, this rollback of coverage is something that women have been concerned about since the election last November.

UConn Student Health Services Women’s Clinic. Everyday, APRN Patricia Moriarty sees about 16 female patients, half of them are for birth control.

“Students, or patients in general, are nervous about the thoughts of changes in birth control,” she says. “Soon after the election, we had an influx of patients that wanted to consider a Long Acting Reversible Contraception [or LARC] method, because they were very, very worried about whether or not their birth control would be covered.”

LARC methods are seeing this spike in demand because they typically last anywhere from 3-10 years which encompasses the period of the Trump presidency, according to Moriarty. A LARC method is a one-time payment for a long-term result, which makes it desirable for women who fear their health insurance plans may change in the near future.

Moriarty says she sees about 16 patients a day, and at least half of them come in for reasons relating to birth control.

Now, the worry has materialized into real trouble. Beyond the obvious concerns that come when news breaks that certain medications that some women rely on may no longer be covered by some insurance providers, it is also worth exploring the downsides that come with having an administration that misunderstands such an important component of women’s health.

The stipulations of the new rule and all supplementary information relating to it can be found on the Federal Register website, which also includes a report from the Institute of Medicine’s [IOM] Report on the outcome of the legislation.

The document cites issues of religious freedoms that have been infringed upon under the Barack Obama-era mandates that required health insurance providers to cover birth control methods that could be used as emergency contraception or that could terminate pregnancies.

On the surface it is a simple issue, but it becomes complicated when taking into account that several daily birth control pills can be used as emergency contraception, as per this chart from Princeton University.

 

Dr. Anthony LoSasso, one of the 16 members of the IOM Committee that was created to assist in the formulation of the new rule, wrote a long letter voicing his dissenting opinion.

LoSasso argued in his letter that there was not sufficient time for the committee to evaluate all scientific evidence of the pros and cons of the services (hormonal birth control) in question during the committee meeting. He also argued that “the committee process for evaluation of the evidence lacked transparency and was largely subject to the preferences of the committee’s composition.”

Though LoSasso was a lone dissenter in the committee that helped to formulate the new rules, his arguments were not without merit. The document cites studies that are almost 30 years old, which, for women’s health studies, is too old.

Those studies say that between 1960 and 1990, as contraceptive use among teens increased, sexual activity outside of marriage increased, as well. The document also cites a nameless study that found that access to emergency contraception did not lower the rate of unintended pregnancies.

These data do not counter the full scope of arguments behind federally funded birth control, as several women take the pill for many reasons outside of pregnancy prevention.

Beth Morana, center manager for the Planned Parenthood in Willimantic, says, “There are advantages and benefits from being on birth control outside of pregnancy preventions. Birth control could help women who have ovarian cysts, it could help women with very heavy menstrual periods and it could help women who have severe menstrual cramps. Certain pills have been proven to help with acne, so there are a number of non-contraceptive reasons to take birth control.”

In terms of pregnancy prevention, however, data from the Center for Disease Control from 2013 says that from then since 2006, unintended pregnancies have dropped among women of reproductive age by 6 percent.

Those statistics more accurately reflect how the Obama-era mandates that birth control be free and accessible for all women affected the rate of unintended pregnancy, as opposed to a study done in the 1990s.

These inaccuracies have the potential to cost women their livelihoods. “Not being able to afford birth control would be one of the most detrimental things to ever happen to me,” said Zappulla. “My work and social life would suffer, as well as my well-being… I would have no control over myself.”

Women as well as providers are searching for ways to combat the loss of control women could be facing in the coming years. One of the biggest ways women are taking action is by beginning LARC methods of birth control such as intra-uterine devices or birth control implants, according to Moriarty.

Moriarty also mentioned that Walmart has created a program that offers a choice between two different birth control pills that women can buy for only $9 a month. This is an option that is currently utilized by university women who do not want the birth control cost to show up on their health care bill for confidentiality purposes, according to Moriarty.

Additionally, funds at Planned Parenthood go directly to providing low cost contraception to women all over the country, as well as here in Willimantic.

Looking forward, there are several more attempts to make contraception harder to attain for women. In the past two years only, there have been four bills introduced to try and defund Planned Parenthood.

In addition to attempts to make contraception harder to come by, there have been nine attempts at passing the Pain Capable Unborn Child Act in the past 10 years, which would harm access to safe and legal abortion services.

“We’re in a system where [they’re] manipulating our choices, and I think it’s wrong,” says Moriarty. “It shouldn’t be a choice between a legislature and somebody, it should be a choice between their medical provider and themselves.”

**In Mass., the Senate overwhelmingly passed a bill on Tuesday, Nov. 12 to ensure free birth control for women in light of the new federal rule.

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