From Our Partners

Contraception: Why Access, Choice, and Price Matter

This post is part of a monthly blog series profiling viewpoints from leaders in reproductive health who are members of the Bellagio Group on Long-Acting Reversible Contraception. The Bellagio Group is a coalition of experts who convene annually to discuss practices for expanding contraceptive choice and accelerating progress toward the Millennium Development Goal of universal access to reproductive health services. This post represents the views of the authors, and is not a representation of the Population Council or the Bellagio Group. Please direct any questions to the author at  

When we talk about challenges in the realm of family planning, we may often speak of countries with high fertility rates or places where women must have their husband’s permission to use contraception. It is easy to forget that it was only in 1965 that the US Supreme Court legalized the oral contraceptive pill for married women and 1972 that the Court legalized oral contraceptives for unmarried women.

The ruling in the recent Hobby Lobby Supreme Court case is a reminder that family planning is not only a developing-world challenge, and that women and men in the United States also face many challenges as they try to make personal decisions about when and how to have a family.

Studies tell us that postponing the decision to start a family is strongly related to increased household income and with the ability to pursue more educational opportunities and achieve greater socioeconomic status. Put another way, the ability to determine when we start a family enables us—and our children—to pursue our dreams. With all of the gains and benefits of family planning, why would anyone want to reverse progress?

In addition to political factors, there are at least two major challenges to realizing universal access to contraception. One challenge is ensuring women and men have full access to information about their contraceptive options, including a range of short- and long-acting, reversible methods. Information should include things such as efficacy, contraindications, side effects, etc. Many of us look to healthcare providers for accurate, unbiased information—so it is important that providers are trained with up-to-date information and, when applicable, when a patient is interested in a specific method, that providers know how to insert long-acting methods, such as implants and intrauterine devices (IUDs).

A second challenge is price. In the United States, the Affordable Care Act (ACA) is making a big difference. However, millions of people could potentially fall through the cracks—for example, daughters may not want contraception appearing on an insurance bill that goes to their parents. Undocumented immigrants who are not eligible for coverage also face unique barriers. And, as we have seen in the Hobby Lobby decision, some employers continue to deny women insurance coverage for contraceptives.

The nonprofit pharmaceutical company I founded, Medicines360, is addressing these barriers by developing a high-quality, affordable hormonal IUD. The WHO, CDC, FDA, and American College of Obstetricians and Gynecologists (ACOG) concur that IUDs are one of the most effective forms of contraception available. The Guttmacher Institute states that IUDs are 45 times more effective than an oral contraceptive. Our plan is to eventually commercialize our products through the private sector and then use profits to subsidize IUD costs in the public sector and in developing countries.

But we know that as one organization we cannot solve the access problem on our own. Addressing the access challenges will require creative solutions and true partnership. That is why we are working with others in the reproductive health community—service providers, a major pharmaceutical company, grassroots organizations, researchers, and international NGOs, to name a few.

Let us commit to work together to improve access to the best contraceptives. For it is only by working together that we will succeed in achieving universal access to contraception and enable women and men to pursue their dreams and decide their own destiny.

Other posts in this series: