Young Women's Health Care Needs Are No Laughing Matter

From Media Matters


Right-wing media are now resorting to mocking female university students' health care needs and their call that religiously affiliated colleges and universities provide access to contraceptives. But studies have found that numerous benefits (medical, social, and economic) exist in providing college-aged women -- the most vulnerable demographic for unintended pregnancies -- affordable access to contraception.

Law School Student Testifies About Need For Contraceptives Coverage

Sandra Fluke: "Forty Percent Of Female Students At Georgetown Law Report Struggling Financially" Due To Fact That University Insurance Does Not Cover Birth Control. In her prepared remarks at a congressional hearing, Georgetown Law Student Sandra Fluke stated:

Without insurance coverage, contraception can cost a woman over $3,000 during law school. For a lot of students who, like me, are on public interest scholarships, that's practically an entire summer's salary. Forty percent of female students at Georgetown Law report struggling financially as a result of this policy. One told us of how embarrassed and powerless she felt when she was standing at the pharmacy counter, learning for the first time that contraception wasn't covered, and had to walk away because she couldn't afford it. Women like her have no choice but to go without contraception. Just last week, a married female student told me she had to stop using contraception because she couldn't afford it any longer. Women employed in low wage jobs without contraceptive coverage face the same choice.

[...]

These denials of contraceptive coverage impact real people. In the worst cases, women who need this medication for other medical reasons suffer dire consequences.

[...]

One student told us that she knew birth control wasn't covered, and she assumed that's how Georgetown's insurance handled all of women's sexual healthcare, so when she was raped, she didn't go to the doctor even to be examined or tested for sexually transmitted infections because she thought insurance wasn't going to cover something like that, something that was related to a woman's reproductive health. As one student put it, "this policy communicates to female students that our school doesn't understand our needs.". [Law Students For Reproductive Justice, 2/23/12, via ABC News; 2/23/12, C-SPAN]

Conservative Media's Response: Women Are "Sluts," "Prostitutes" For Demanding Contraception Coverage

Rush Limbaugh: Fluke Says "She Must Be Paid To Have Sex," So She's A "Slut ... A Prostitute." On his radio show, Rush Limbaugh said: "What does it say about the college coed Susan [sic] Fluke who goes before a congressional committee and essentially says that she must be paid to have sex. What does that make her? It makes her a slut, right? It makes her a prostitute. She wants to be paid to have sex." He continued: "She's having so much sex, she can't afford the contraception. She wants you and me and the taxpayers to pay her to have sex. What does that make us? We're the pimps." He added: "OK, so, she's not a slut; she's round-heeled. I take it back." [Premiere Radio Networks, The Rush Limbaugh Show, 2/29/12]

CNS News: "Sex-Crazed Co-Eds Going Broke Buying Birth Control, Student Tells Pelosi Hearing." In a widely cited article from CNS News headlined, "Sex-Crazed Co-Eds Going Broke Buying Birth Control, Student Tells Pelosi Hearing Touting Freebie Mandate," Craig Bannister wrote:

$3,000 for birth control in three years? That's a thousand dollars a year of sex -- and, she wants us to pay for it.

[...]

So, she earns enough money in just one summer to pays [sic] for three full years of sex. And, yes, they are full years -- since she and her co-ed classmates are having sex nearly three times a day for three years straight, apparently.

At a dollar a condom if she shops at CVS pharmacy's website, that $3,000 would buy her 3,000 condoms -- or, 1,000 a year. (By the way, why does CVS.com list the weight of its condom products in terms of pounds?)

Assuming it's not a leap year, that's 1,000 divided by 365 -- or having sex 2.74 times a day, every day, for three straight years. And, I thought Georgetown was a Catholic university where women might be prone to shun casual, unmarried sex. At least its health insurance doesn't cover contraception (that which you subsidize, you get more of, you know).

[...]

Besides, maybe, these female law students could cut back on some other expenses to make room for more birth control in their budgets, instead of making us pick up the tab. With classes and studying and all that sex, who's got time for cable?

And, let's not forget about these deadbeat boyfriends (or random hook-ups?) who are having sex 2.74 times a day. If Fluke's going to ask the government to force anyone to foot the bill for her friends' birth control, shouldn't it be these guys? [CNS News, 2/27/12]

Fox News' Trace Gallagher: "See, I Was Gonna Go To Law School, But I Thought All You Did Was Study ... I Guess I Was Wrong." Discussing Fluke's testimony, correspondent Trace Gallagher said: "And see, I was gonna go to law school, but I thought all you did was study in law school, right? So, I guess I was wrong on that." Host Megyn Kelly replied: "This is what we worried about. When I was in law school, this is what we worried about -- getting coverage of our contraceptives." [Fox News,America Live, 2/28/12]

Fox News' Monica Crowley: "It's Not A Right Under The Constitution To Have Sex." On America Live, Fox News contributor Monica Crowley responded to Fluke's testimony by repeatedly arguing that the debate on women's health care issues was about "recreational sex." She said: "Cry me a river. ... Cry me a river. Now the American people are supposed to be paying for somebody to have sex. ... Listen, the tuition is $63,000 total cost and you're telling me that they can't afford $3 for a condom?" She added, "It's not a right under the Constitution to have sex," and concluded: "There is an alternative to this if you can't afford the condom or the birth control bills, which is abstinence: You just don't have sex." [Fox News, America Live, 2/29/12]

CNN's Dana Loesch: "They Act Like They're Nymphos. That's What They Act Like." On her radio show, CNN contributor Dana Loesch ridiculed college-aged women for wanting access to contraceptives, saying, "She's doing it more than she's studying in law school. Is that why our -- is that why law sucks lately? Is that why we're having such a problem in our courts?" Loesch went on to say: "They act like they're nymphos. That's what they act like." She also accused young women and feminists of "supporting female genocide" and said that young women's call for contraceptives coverage is "insulting to the original spirit and intent of the suffrage movement." [KFTK, The Dana Show, 2/28/12]

Right-Wing Media Deny That Women Even "Need" Contraceptives

Big Government: "Most Women Don't Need Birth Control." In a post on Andrew Breitbart's Big Government website, blogger Charles C. Johnson claimed that "most women don't need birth control" and went on to say:

[I]f the cost of keeping her ovary was a mere $3,000 a year, why couldn't her gay friend -- assuming she actually exists -- take time off of law school to save up for her birth control? Why couldn't we mandate coverage for women who have the disorder of polycystic ovary syndrome? And if her insurance won't cover it, why can't she go and pick up a pack of $9 a month pills from Target? What's more who said she had to go [to] law school at Georgetown, a Jesuit law school? If birth control were such a serious criteria in one's life, wouldn't you choose your law school accordingly? Fluke says that women should refuse to choose between their health and a quality education, but adult life is about making just such choices. [Big Government, 2/29/12]

Hot Air: Contraception Is Not A Medical Necessity. In a post at right-wing blog Hot Air titled, "Georgetown co-ed: Please pay for us to have sex ... We're going broke buying birth control," Tina Korbe wrote that "women can make lifestyle choices that render [contraceptives] unnecessary," and argued that access to contraceptives is related solely to women's "sexual urges." She concluded:

Ms. Fluke, I resent that you think women are incapable of controlling themselves, of sacrificing temporary pleasure for the sake of long-term success. You make us sound like animals, slaves to our instincts and able to be used, but we're better than that. We're persons, equal to men in dignity and love. [Hot Air, 2/28/12]

Fact: Young Women Need Contraceptives For More Than Just Pregnancy Prevention

Guttmacher Institute: Contraceptives "Help Alleviate A Range Of Immediate Health Problems Experienced By Women, And Young Women In Particular." In its study, the Guttmacher Institute found that birth control pills, "as well as other hormonal contraceptive methods, not only reduces the risk of unintended pregnancy, but also helps alleviate a range of immediate health problems experienced by women, and young women in particular." Guttmacher stated:

Oral contraceptive pills (OCPs) are primarily intended to prevent pregnancy. But they also offer a number of additional and immediate health benefits, particularly for women who experience menstrual-related disorders. According to the American College of Obstetrics and Gynecology (ACOG), OCPs help relieve or reduce the symptoms of severe menstrual pain (dysmenorrhea), which is experienced by up to 40% of all adult women and can lead to absences from work and school. The pill (as well as other hormonal contraceptives) is useful in treating excessive menstrual bleeding (menorrhagia), which can lead to anemia, and it also has the potential to reduce acne and excess hair growth (hirsutism).

Other noncontraceptive uses include prevention of menstrual-related migraines, and treatment of pelvic pain that accompanies endometriosis and of bleeding due to uterine fibroids. Additional benefits identified by ACOG are normalization of irregular periods and suppression of menstruation. For some women, predicting when they will have their period or avoiding it altogether may be a matter of convenience; for others, menstrual regulation may help prevent migraines and other painful "side effects" of menstruation. [Guttmacher Institute,November 2011]

Fact: Young Women Face Higher Rates Of Unintended Pregnancies

Former Association of Reproductive Health Professionals Chairman: "College Women Are At The Highest Risk For Unintended Pregnancy." In an article about the burden college students face when the price of contraceptives increases, The Wall Street Journal reported:

To save money, at the University of Iowa, about three-fourths of students on Ortho Tri-Cyclen Lo -- a pill that has no generic form -- have switched to a less-expensive option.

Such changes concern health professionals, who fear that switching is going to lead to unintended pregnancies by women who are less likely to consistently take a daily pill. "One of the seminal concepts in contraceptive medicine is when a woman is using a method correctly and successfully, the last thing you want to do is change her from that," says Lee Shulman, board chairman of the Association of Reproductive Health Professionals. "You don't want to change her unless there is an absolute medical necessity to do so."

He says even switching from one type of daily pill to another can pose new risks for side effects and discomfort, potentially leading women to stop taking it.

[...]

Health professionals say it's particularly critical for college women to have access to cheap contraception. Two-thirds of college students reported having at least one sexual partner in the prior 12 months, according to a fall 2006 survey of more than 23,000 students by the American College Health Association. Condoms have been available free on many campuses, and are considered the best form of contraception for preventing sexually transmitted infections.

"Maybe, if more people switch from hormonal methods to condoms, we may see a positive outcome of fewer STI's," says Mary Hoban, a project director for the American College Health Association. "But from a contraceptive standpoint, we may see more unintended pregnancy. It's a double-edged sword."

About 40% of sexually active college women reported relying on pills and other prescription forms of birth control, according to the ACHA data.

"College women are at the highest risk for unintended pregnancy because they're sexually active, they're very fertile, and they are away from home," says Dr. Shulman, adding that students count on their health service for a host of reasons, from counseling to testing for sexually transmitted diseases, to birth-control prescriptions. [The Wall Street Journal,7/26/07]

Health Center Administrator: "Pregnancy Rates Among 18- To 24-Year-Olds Remain Excessive."In an article on the unintended pregnancy rate of unmarried female college students, the Internal Medicine News reported:

Data from the Spring 2007 National College Health Assessment showed that, overall, 2.6% of unmarried sexually active female students aged 18-24 years at western U.S. colleges experienced an unwanted pregnancy during the past year. The rate was 5.3% among 1,433 attendees at 2-year colleges and 1.8% in 4,732 at 4-year schools, Lisa L. Lindley, Dr.PH, reported at the annual meeting of the American Public Health Association.

[...]

Dr. Lindley explained that the college study was undertaken in an effort to better understand the phenomenon of unintended pregnancy. Half of all pregnancies in the United States are unintended. Among young unmarried women this figure is far higher: 73% among 20- to 24-year-olds, and 86% in those under age 20.

Solid progress has been made in reducing the national pregnancy rate among 15- to 17-year-olds. But pregnancy rates among 18- to 24-year-olds remain excessive, she said. [Internal Medicine News Digital Network, 1/7/11]

Fact: Restricting Young Women's Access To Contraceptives Results In A Variety Of Negative Consequences 

College Health Center Director: "We Do Know That High Fees Act As A Barrier To Obtaining [Contraceptive] Care." A Time magazine article examining the effect of the rising costs of contraceptives on college students reported:

A 2006 survey conducted by the American College Health Association (ACHA) found that 39% of undergraduate women use oral contraceptives. Many providers are afraid that if the convenience of free or cheap birth control on campus is taken away, female students might just get turned off by prescription birth control methods altogether and use other less effective ones like condoms or Plan B, known as the morning after pill. Even switching to generic medications, most say, while better than nothing, isn't ideal because of the side effects that sometimes come along with them. "We do know that high fees act as a barrier to obtaining care. That is classically understood in campus health services," says Claudia Covello, director at the University of California-Berkeley's health center. [Time, 8/12/07]

Study: Restricting Young Women's Access To Contraceptives Results In A Variety Of Consequences. In a study analyzing the impact on college students when the price of contraceptives increased, researchers at the University of Michigan found:

With the passage of the Deficit Reduction Act of 2005, Congress inadvertently and unexpectedly increased the effective price of birth control pills ("the Pill") at college health centers more than three-fold, from $5 to $10 a month to between $30 and $50 a month. Using quasi-difference-in-difference and fixed effects methodologies and an intention-to-treat (ITT) design with two different data sets, we find that this policy change reduced use of the Pill by at least 1 to 1.8 percentage points, or 2 to 4 percent, among college women, on average.

For college women who lacked health insurance or carried large credit card balances, the decline was two to three times as large. Women who lack insurance and have sex infrequently appear to substitute toward emergency contraception; uninsured women who are frequent sex participants appear to substitute toward non-prescription forms of birth control. Additionally, we find small but significant decreases in frequency of intercourse and the number of sex partners, suggesting that some women may be substituting away from sexual behavior in general.

[...]

Overall, these results suggest that college women did reduce their use of the Pill in response to the price increase, and that the reductions were larger among lower income, more credit constrained women and women without health insurance. Additionally, we find that the alternatives employed by women differed based on their frequency of sex and their debt and insurance status. Women without insurance were more likely to increase their usage of EC [emergency contraception] and non-prescription methods of birth control, while women with moderate to high amounts of debt increased use of EC, but we notice increases in non-prescription birth control among only moderate debt women. Infrequent sex participants appear to have been more likely to switch to no method, while frequent sex participants appear to have been more likely to reduce their number of sex partners. Although we find no evidence of increases in STI infections or accidental pregnancy for most affected women, we cannot rule out that the most credit constrained women did suffer an increase in the risk of unintended pregnancy. [Population Studies Center, University of Michigan, May 2011]

Fact: Early Access To Contraceptives Can Boost Women's Economic, Educational Potential

Study: Women's Early Access To Contraceptives Significantly Improves Their Economic And Educational Opportunities, Narrows U.S. Gender Gap. A study by economists from the University of Michigan and the University of Virginia found that contraceptives have a significant impact on women's educational and economic opportunities. They argued that contraceptives are at the "root cause" of the boon in female college enrollment and workplace employment from the 1970s on, because they "improved [women's] ability to time births, altered their expectations about future childbearing, and reduced the cost of altering career investments to reflect their changed expectations." The study also found that "younger access to the Pill conferred an 8-percent hourly wage premium by age fifty" and concluded that "the Pill can account for 10 percent of the convergence [of] the gender gap in the 1980s and 30 percent in the 1990s." [University of Michigan, 12/13/11]

Fact: Unplanned Pregnancies Increase College Drop-Out Rate, Abortions

Study: "Unplanned Pregnancies Increase The Risk Of Dropping Out" Of College. In a 2009 report on unplanned pregnancies on community college students, the National Campaign to Prevent Teen and Unplanned Pregnancy found:

• Unplanned pregnancies increase the risk of dropping out or stopping out of college--61% of women who have children after enrolling in community college fail to finish their degree, which is 65% higher than the rate for those who didn't have children.

• Unplanned pregnancies can increase emotional and financial stress on the young men and women involved, which can impede academic performance.

• Unplanned pregnancies can also add to the overall costs of operating community colleges themselves, through increased demand for child care and related support services. [National Campaign to Prevent Teen and Unplanned Pregnancy, November 2009]

Study: Free Access To Contraceptives Results In Fewer Unplanned Pregnancies, Abortions. A California study demonstrated that providing access to contraceptives free of charge results in a substantial decrease in unintended pregnancies and by extension, abortions:

Two studies provide evidence that when the barrier of cost is removed, a shift toward the most effective contraceptive methods results. In 2002, California's Kaiser Foundation Health Plan changed its policy to eliminate copayments for the most effective contraceptive methods (IUCs, injectables, and implants) so that they were 100% covered for all users. Before this change, users of these methods had to pay up to $300 for 5 years of use. The elimination of copayments, along with training for health care providers in the use of IUCs, contributed to a 137% increase in their use -- and an estimated 1791 pregnancies averted among Kaiser's patient population. [The New England Journal of Medicine, 5/5/11]

Fact: Unplanned Pregnancies Costs Taxpayers At Least $11 Billion A Year

Guttmacher Institute: "Unintended Pregnancy Costs U.S. Taxpayers Roughly $11 Billion Each Year" -- "A Conservative Estimate." According to the Guttmacher Institute, not only do unintended pregnancies create hardships for women and "can impede their ability to reach their full potential," they also result in a steep price tag to the public to the tune of about $11 billion a year -- "a conservative estimate." The report added that "the true cost would actually be many times higher if other expenses, such as social supports or ongoing medical care, were considered." Guttmacher added:

Nine in 10 women who would have become pregnant in the absence of publicly subsidized family planning would be eligible for a Medicaid-covered birth if they were to become pregnant.

Accordingly, family planning services subsidized through Medicaid, Title X and other federal and state funding streams are not only effective, they are highly cost-effective: Every dollar spent to provide these services not only helps women achieve their own childbearing goals, it also saves taxpayers almost $4 in Medicaid costs. In the absence of the publicly funded family planning services already being provided, the already steep cost of unintended pregnancy would balloon by about 60%, to $18 billion a year. [Guttmacher Institute,Summer 2011]