Is contraception healthcare?
Given the continuing kerfuffle over mandated insurace coverage for contraception, I thought I would step back and consider a few basic questions.
- Is (hormonal) contraception healthcare?
- clearly, yes; the pill is used to treat medical conditions, such as polycystic ovary syndrome.
- Are other forms of contraception (e.g., IUDs, condoms, surgical interventions), or the use of the pill for contraceptive purposes, healthcare?
- Note: I assume, as an axiom, that pregnancy is not, in itself, an illness which requires prevention or treatment.
- The answer to this question is more complex than #1, but only slightly more so:
- Even if pregnancy is not an illness, it is nonetheless a healthcare issue, carrying with it health risks that must be managed; it is therefore worthwhile to enable humans* to avoid assuming these risks if they would rather not.
- There are health benefits for mother and child (and familes) of controlling the spacing of pregnancies; contraception aids in accomplishing this.
- Are other methods of controlling pregnancy (i.e., celibacy or fertility awareness methods) acceptable alternatives?
- In regard to the "rhythm method": no; fertility awareness has a lower 'actual use' effective rate than most other methods.
- In regard to celibacy, there are actually health benefits to non-procreative intercourse.
- (Yes, I've conveniently ignored the ethical issues of healthcare decision-making, and the many gendered sociological considerations surrounding sex - those are topics for another blog)
- Are there public health or economic benefits of increased access to contraception?
- Yes; for some contraceptive methods, decreased risk of sexually transmitted infections (on a related note, there is an argument to be made for the public health benefits of greater promiscuity).
- For hormonal methods, there are both risks and beneficial side-effects. This is true of most drugs, of course, and as with most drugs, the cost-benefit analysis is usually left to the patient and doctor (and, unfortunately, the insurer).
- As the article above notes, having more women on birth control provides more opportunities for reproductive and non-reproductive preventive care.
- As noted above, mothers and children are healthier when women have more control over their fertility. This is likely to lead to better health outcomes and cost savings system-wide.
In sumary, this seems like a pretty strong case that contraception is a form of healthcare, and deserves consideration in the healthcare policy debate. Whether the current insurance infrastructure provides the means to effectively deliver this remains a separate question.
* I say 'humans' because I (as a male) assume men have an interest in whether their partners become pregnant.