Access to contraception may be restricted, advocate for abortion

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The Supreme Court’s decision to overturn the fundamental right to abortion has raised fears among some Americans that restricting access to contraceptives could be the next step.

Birth control remains legal in the United States, but abortion rights advocates and medical providers have warned that a reversal of roe could be used to restrict access to contraception. For many, those fears were confirmed by Judge Clarence Thomas’s unified opinion, in which he said the Supreme Court should review previous decisions, including one protecting the right to obtain contraception.

Some state lawmakers may also try to curb access to birth control. Most medical providers agree that birth control methods only serve to prevent a pregnancy before it begins, but some anti-abortion organizations oppose certain methods of birth control, saying they can terminate a pregnancy rather than prevent it.

Now that Roe v. Wade has been quashed, the legality of abortion has been left to the states. Some worry that access to certain forms of birth control could be the next step. (Video: Julie Yoon, Hadley Green, Sarah Hashemi/The Washington Post)

Responding to the reversal of roe deer, Jennifer Lincoln, a board-certified OB/GYN in Portland, Oregon, said, “The next ones are emergency contraception and IUDs, then all hormonal contraception. It’s about complete reproductive control, so this is just the next logical step for [conservatives]†

Since Politico published a leaked draft opinion suggesting: roe would be destroyed, Lincoln said she has received an influx of questions via social media about how to access long-acting contraceptive methods like IUDs — and how long that access could take. Google searches for IUDs, plan B and birth control have increased in recent weeks and many people on social media have wondered whether to start getting emergency contraception or plan B in case they are no longer available.

Anne Cavett, a nurse practitioner and clinical services coordinator at Metropolitan Washington’s Planned Parenthood, thinks those fears are well-founded: “I don’t think it’s alarming to fear it’s getting worse,” she said.

Cavett added that in recent weeks more people at her clinic have been asking for long-acting contraceptives and many patients have expressed concerns about how long they will be available. Some patients, she said, have come in to have their IUDs replaced before their due date; they’re afraid it’s their last chance.

“I think, overwhelmingly, when someone hears that the right to abortion has been scrapped, there’s a fear that you’re losing the right to your physical autonomy and the ability to make your own decisions,” Cavett said.

Some anti-abortion organizations are against certain birth control methods. Most medical professionals believe that pregnancy begins when a fertilized egg implants itself in the uterus, but some opponents of abortion believe it begins as soon as an egg is fertilized by sperm.

“We’re not taking a stance on contraception — which prevents pregnancy — but on abortions that, as a deliberate part of their design, have the capacity and purpose to end the life of an unborn baby,” said Kristi Hamrick, a spokesperson for the anti-aging agency. abortion organization Students for Life of America.

The list of “abortions” that Students for Life of America opposes includes birth control pills, IUDs, and plan B. They take no position on condoms, sterilization (tubal ligation or vasectomies), or the rhythm method — which involves tracking the menstrual cycle and monitoring body temperature and is about 76 percent effective at preventing pregnancy.

According to the American College of Obstetricians and Gynecologists, emergency contraception such as Plan B is sometimes confused with drug abortion. But “medical abortion is used to terminate an existing pregnancy, while emergency contraception is only effective before a pregnancy is established.” The organization also says the copper IUD functions by “affecting sperm viability and function,” not preventing implantation.

“This misinformation is what lawmakers use to base their arguments on — that IUDs and emergency contraceptive pills are abortifacient,” Lincoln said. “They use it directly as a way to then write laws to ban access to these drugs. This will lead to reduced access and, as a result, more unplanned pregnancies and people seeking abortions.”

IUDs are one of the most effective forms of birth control, lasting up to a decade, according to the Centers for Disease Control and Prevention. More than 10 percent of American women who use birth control rely on long-acting reversible methods such as IUDs. They’re also used to treat heavy menstrual bleeding, in some cases even avoiding the need for a hysterectomy, Lincoln said. There are two types of IUDs: copper, which prevents sperm from reaching an egg, and hormonal, which thickens cervical mucus and blocks sperm. In some rare cases, IUDs can prevent implantation of a fertilized egg into the uterine lining.

Emergency contraceptives, meanwhile, delay ovulation after unprotected sex so that there is no egg to meet the sperm. According to the Center for Disease Control, nearly one in four women between the ages of 20 and 24 has used emergency contraception.

Thomas’s unified opinion raised concerns for abortion advocates that the right to contraception may be overturned by the courts.

“In future cases, we must reconsider all substantive precedents of this Court, including: GriswoldLaurentiusand Obergefell‘ wrote Thomas. Griswold refers to Griswold v. Connecticut, the 1965 ruling that overturned a law in Connecticut that banned the purchase of anything that “prevents birth control,” thus entrenching married couples’ right to purchase and use contraception. 1972, Eisenstadt v. Baird extended that right to unmarried persons. †Laurentius and Obergefell are related to same-sex relationships and marriage.)

But Thomas’s opinion isn’t the first sign to suggest some states may restrict access to contraceptives. In Idaho, Brent Crane, chair of the state affairs committee, announced his plans shortly after the advisory draft leak to hold hearings on whether emergency contraception and possibly IUDs should be banned. He later clarified that he was not talking about IUDs, but that he was open to holding hearings on “the issue of abortions.”

Last month, lawmakers in Louisiana introduced a bill defining “human personality” as beginning at the time of conception, which some experts believe could be used to address Plan B or IUDs. And last year, in Missouri, lawmakers tried to prevent Medicaid from covering Plan B and IUDs.

It’s not yet clear whether these efforts will succeed in blocking access to contraception, but medical providers say contraception is already difficult to access in much of the country.

“There are a lot of challenges and roadblocks that people have in accessing birth control in this country — and it’s horrendous,” Cavett said.

According to a study, low-income and people of color are more likely to live in “birth control deserts,” or areas where there aren’t enough clinics to provide contraception. For the more than 30 million Americans without health insurance, contraceptives can be prohibitively expensive. And even among women with private insurance, one in five contraceptives still pays partially or completely out of pocket, according to the Kaiser Family Foundation.

It’s important for people to know that all birth control methods remain legal, Lincoln said. However, she warned that this may not be the case forever — and encouraged people to consider their birth control options.

Lincoln started a website where people can order birth control, emergency contraception, and prescription abortion pills, and other abortion advocates are stepping up their efforts to increase access to birth control over the Internet.

However, for the 21 million Americans without broadband connectivity, even this plan could pose challenges.

“There’s already a disparity about who can and cannot access these methods,” Cavett said. “They are inevitably black and brown people, transgender and non-binary people, people who live in rural areas, people with low incomes. These are all the people who are already overloaded with it.”

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