By Katie Maningas
Recently, Donald Trump’s administration issued a ruling allowing employers to decline providing birth control to their employees if it violates their “religious beliefs” or “moral convictions,” a direct override of a provision under Obamacare that required employers to provide free birth control. Although Obamacare permitted religious institutions to abstain from providing birth control to their employees, this decree expands that allowance to any institution or organization that believes it contradicts their beliefs.
Though the Health and Human Services Department claims that very few women will actually lose access to their birth control because “a small percentage” will choose to opt out of the mandate, health policy analysts warn that if employers believe that it will save their company enough money, it might serve as a loophole to deny their employees this coverage.
What some may not realize is that birth control could be normalized in the same way as getting a flu shot, purely on the basis that it provides positive externalities. Meaning, there are unintended spillover effects that positively contribute to society. Consider the history of birth control: before it was invented, couples tried all sorts of cultural remedies from crocodile feces in Ancient Egypt to using a half lemon as a cervical cap. Of course there were other contraceptives that predated the birth control pill, such as condoms and diaphragms, but even then, on average almost 20% of women would become pregnant despite using them. The birth control pill on the other hand, only has a failure rate of about 6%. What did this mean for American women when it was legalized in the 1970s? The freedom the pill afforded allowed women to get professional degrees and invest in professional, more lucrative careers. Fewer children were being born, which meant fewer life-time investments and high spending on things such as college. So what did this mean for America? More money. Now to put this situation in a more modern context, when the Affordable Care Act was released in 2010, it required companies using the program to provide birth control for free, whereas in previous generations, women could be paying as much as $50 per pack without insurance. The result? All taxpayers saved roughly $1.32 bn on average per year, according to a study by Brookings.
This situation doesn’t just apply to the US women; it is relevant globally. Unfortunately, there are about 214 million women of reproductive age in developing countries who do not have access to a modern contraceptive method, for reasons such as cultural/religious opposition, poor quality of services, or just outright fear. But what could happen if more women in developed nations had access to quality contraceptives? A quick look at Ethiopia will paint the revolutionary effects of contraceptives for developing nations.
In 1990, Ethiopia’s contraceptive prevalence rate (CPR) was a mere 2.9 percent. Furthermore, the country’s total fertility rate (TFR) was an average of 7 children per woman and a maternal mortality rate (MMR) of 1,250 per 100,000 live births. But after a successful introduction of contraceptives, thanks to the cooperation of the Ethiopian government, generous donor support, nongovernmental organizations and public-private partnerships, and a health extension program initiated by the government, by 2011, the CPR quadrupled to 27.3 percent, the TFR dropped to 4.8 children, and the MMR also decreased to 482 deaths. In the real world, these numbers translate to more opportunity for Ethiopian women and mothers. Although the rate is still comparatively low, both in sub-Saharan Africa and globally, more than double the amount of women from 1990 have more opportunities for mobility. During the period of 1990 to 2011, the primary school enrollment for females more than tripled from 28 percent to 91 percent, labor participation rate for women increased from 71 percent to 78 percent, and almost a fifth of senior or middle management is now controlled by women.
While it’s true that contraceptives may not be the only cause for these changes, it cannot be denied that it is a sizable factor. Having the ability to better manage how many children they had allowed Ethiopian women to spend less time raising them and doing domestic work, which rendered them the opportunity to go to school and pursue less labor intensive jobs, thus giving them social mobility, stability, and independence. Ethiopia’s story strengthens the argument that birth control not only provides women worldwide with more opportunities, but it allows for them to contribute back to their community and their economies; thus improving the overall well being of their entire country.