Redefining Access for Women in America

Access to medicines. Everyone agrees we should have it, but what does the concept really mean?

We both run organizations founded to address unmet public health needs and have seen problems with access to medicines play out in different ways. For example, during a natural disaster, access to medicines can literally be limited by impassable roads. During an infectious disease epidemic, there might not be enough vaccines stockpiled for everyone at risk. When it comes to women’s reproductive health here in the U.S., “access” takes on a more complex meaning. In our prosperous nation, the issue isn’t the supply of contraceptives, or even demand.

From our point of view, true access in the context of women’s reproductive health means that every woman, regardless of where she lives, how much money she makes, or her health insurance status, should be able to choose if and when to have a baby. However, the reality is that not every woman in the United States has this choice.

Disparities in contraceptive access occur for many reasons, such as levels of provider training. However, one major challenge persists – the most effective forms of contraception according to the CDC, long-acting reversible contraceptives or LARCs (including IUDs), are expensive and cost-prohibitive for too many women. This is particularly true for those without health insurance and with low incomes, who are among the most affected by unplanned pregnancies. This issue persists even though we see decreases in both unplanned pregnancy and healthcare costs when women can choose the most effective forms of birth control.

As leaders of mission-driven, nonprofit organizations, it’s part of our goal to sustain the supply of effective contraception for women who are not guaranteed access – such as the nearly 14 million women who are uninsured in America.

Empowering every woman to space their children or avoid a pregnancy they neither desire nor plan has profoundly positive effects on the course of their individual lives. Why? For many reasons, including that unplanned pregnancies are often associated with negative outcomes such as premature birth, maternal depression, and other lifelong health, economic, and societal difficulties.

So, what are we going to do about it? To start, our organizations are joining forces to donate Medicines360’s hormonal IUD free of charge to selected clinics that serve women who cannot obtain the effective contraception through private insurance, Medicaid, or other public funding.

We’re targeting clinics in states across the country, starting with Virginia, Texas, Colorado and Kentucky, all of which have populations of women who need and deserve access to reliable contraceptive options. Our motivation to increase access across the country stems from the fact that more than 19 million women in the United States live in so-called “contraceptive deserts,” where no access exists to publicly funded clinics providing the full range of FDA-approved contraceptive methods. We cannot allow such disparities to continue and we’re hopeful our efforts can help overcome structural barriers surrounding provider training, patient education and advocacy, so that all women have full reign over their lives and healthcare.

This venture marks the first consistent supply of contraceptives offered through Direct Relief, and the demand that led to this joint program was strong evidence of the ongoing, unmet needs in women’s health. We have long sought to collaborate in ways that enable increased access to healthcare products and services for people who need it most. In 2018, women in our own country are among them.

The profound benefits of expanding access to contraceptive choices are crystal clear, and consequences of inaction and maintaining the status quo are widespread and unacceptable. That’s why we’re looking to leaders from across the industry to step up and help find ways to offer all women the full range of contraceptive options. Count us in.