Women’s Health Care Coverage

The debate has started again about what services should and should not be covered by health insurance.  Religious organizations feel that they should be able to not cover birth control.  If they don’t believe in it as a religious policy, they should not pay for it as part of their insurance policy.

I thought we had finally finished fighting this battle.  Sigh.  Here we go again.  I have had to deal with insurance companies (and parents sometimes) about this for years.  People – this is not the 1950s. 

1.     The choice of whether or not to have children belongs with the woman who is having the children.  It does not belong with anyone else.  As a physician, I can only assist in this decision. 

2.     The choice of birth control method also belongs with a woman.  Her partner may or may not be involved in this decision.  My job is to educate her and assist in this decision.

3.     Birth control is not always used to prevent pregnancy.  We use birth control pills to control bleeding, keep cycles regular, assist with acne control, aid in controlling cramps, help control endometriosis, and many other things.  We use IUDs, patches and other birth control methods for some of the same issues.  Some of the women using these methods aren’t even sexually active.  If the insurance company decides not to cover “birth control”, they won’t cover the medications for any other reason. 

4.     Many of the “covered lives” (shudder at that term) may not be of the same faith as the organization that they work for.  Should they have to live by the same rules?

It is interesting to me that most of the people who are making these arguments are not the ones who are going to have to raise the babies.  Once the babies are born, they aren’t going to have the responsibility for them forever.  It’s only in the abstract that they talk about “the pregnancy”. 

Let’s give them 5 babies, minimum wage, no welfare, no medical assistance, etc, and see how they do!

Birth Control Pill Recall

This news is all over the web, but I want my readers to have it, too.

Pfizer has recalled multiple lots of their birth control pills Lo/Ovral and Norgestrel 0.3mg, Ethinyl Estradiol 0.03mg. 

I know I don’t prescribe a lot of this.  But, if you are on it you should immediately contact your “health care provider”.  Also use a back up method of birth control. 

Evidently some of these have more “reminder pills” (inactive) in them than they should.  So your chance for getting pregnant is higher.  Since the majority of women who are on birth control pills are using them to prevent pregnancy, this needs to be addressed.  For those of you who are using the pill to control your bleeding, you may have issues with your bleeding.  Again, contact your "provider". 

I have a list of the lot numbers, but I can't get it to post on the blog.  Techno - dinosaur strikes again.

No Birth Control = Teen Mom

I have asked this question to teenagers in my office before: “What do you call a woman who doesn’t use birth control and is sexually active?” 

Their answers are interesting.  My favorite is “Stupid.” 

My answer is “Mommy.”

There seems to be a disconnect in teenager’s minds between sex and pregnancy.  A recent article from the Wall Street Journal by Katherine Hobson (http://blogs.wsj.com/health/2012/01/19/why-didnt-teen-moms-use-birth-control/?mod=WSJBlog)  lists some of the reasons that this age group continues to have unintended pregnancies.  The U.S. has one of the highest teen birth rates of developed countries. 

Half of teen moms with unintended pregnancies were using birth control.  That’s scary.  Birth control pills, IUD, injections, patches, rings (highly effective), condoms (moderately effective) and less effective methods.  Some of these require teaching and interaction with health care professionals.  In my experience, some teens have difficulties learning to use some of these methods.

Say what?

What concerns me more is that about half of these moms weren’t using any form of contraception at the time of conception.   Say what?  They had lots of interesting excuses. 

·        I didn’t think I could get pregnant at that time.

·        Partner didn’t want to use birth control

·        I didn’t intend to get pregnant, but didn’t mind

·        Had trouble getting contraception

·        Had side effects

·        Thought they or partner were sterile

What to do?

We argue about sex education in schools.  It certainly doesn’t sound like we are doing a very good job at home.  Abstinence education doesn’t seem to be working very well, either.  It’s a good idea to discuss women being in control of our own bodies and delaying sexual activity as long as possible.  A child is a life-long commitment. 

Women fought long and hard for the right for access to birth control information.  Now it’s time to let us use it, disperse it, pay for it out of insurance or public funding, and let young women have the right to determine when it’s time to bear children. 

Political opinion courtesy of this author, who grew up in them there radical 1960s, when “barefoot and pregnant” was a normal state for many women.

http://blogs.wsj.com/health/2012/01/19/why-didnt-teen-moms-use-birth-control/?mod=WSJBlog