Trump's short-sighted view on contraception will cost us

Trump's short-sighted view on contraception will cost us
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As a gynecologist who cares for adolescents and adults, I provide comprehensive contraceptive services for my patients. Thousands of my patients rely on these contraceptive medications and devices for their noncontraceptive benefits. These are females whose lives are disrupted by heavy menstrual bleeding, painful cramps, random pelvic pain, irregular and unpredictable periods.

From the high school student who misses one or two days of school per month due to disabling menstrual cramps; associated nausea and vomiting, to the executive who cannot sit in a meeting for more than one hour for fear that she will bleed through a super-plus tampon and pad. These hormonal contraceptives allow females to participate in their daily activities and contribute to society, now and in the future.

Recently, the Trump administration announced an immediate end to the Obama-era mandate that employers had to provide contraception at no cost to employees.  This abrupt change in policy now allows employers to opt-out of contraceptive coverage for their employees based on religious and/or moral grounds, without requiring an explanation.


The United States has achieved a 30-year low in unintended pregnancy, and the lowest rates of teen pregnancy and abortion seen in decades, a testament to the benefit of greater contraception access and affordability, as per the Guttmacher Institute. Furthermore, the availability of contraception helps females to achieve educational, career, financial and family goals. One would think this is a win-win-win situation:  good for women’s health, good for the employer's, good for the economy. Unfortunately, our nation’s leaders are short-sighted on this issue.

Adolescent and adult females should be uniting to fight against this mandated change for multiple reasons. The availability of no-cost contraception has been a highlight of ObamaCare, allowing females to access all contraceptive options without concern for upfront cost. And there is significant personal benefit in controlling when one chooses to conceive and in using contraceptives to treat specific gynecologic disorders.

Imagine having a recurring severe medical condition that causes you to miss one or two days of school or work per month, and up to 12 to 24 days per year? After being prescribed certain hormonal contraceptives, females no longer miss one or more days per month of school or work due to incapacitating menstrual symptoms. This adds 12 or more days per year that females are learning in the classroom, helping others, and participating in our country’s economy.

Available hormonal contraceptive options include the oral contraceptive pill, the patch and the vaginal ring (all of which contain estrogen and progestin), the progestin-only pill, progestin injections, the progestin-releasing intrauterine device (IUD), and the progestin implant (for the upper arm). There is also the copper IUD that does not contain any hormones.

Numerous medical studies have substantiated the noncontraceptive benefits of hormonal contraceptives. These benefits include a reduction in heavy menstrual bleeding and painful menstrual cramps, regulation of irregular menses, improvement in menstrual migraines and premenstrual syndrome (PMS), suppression of endometriosis (a condition that causes pelvic pain and can impair fertility), decrease in the risk of uterine and ovarian cancer, and more.

President Trump vows to “Make America Great Again.” Although his support of women’s health issues is questionable at best, he should pay attention to how other countries handle the issue of contraception. America should be proud to join the ranks of other other countries that offer free contraception.

The best version of America empowers females to access contraception to control their ability to reproduce and to manage severe gynecologic conditions. If we marginalize half of the population and impair the ability of females to succeed in school and at work, our country will never realize its full potential.

Beth W. Rackow, M.D., is an associate professor of obstetrics and gynecology and of pediatrics at Columbia University Medical Center, director of the pediatric and adolescent gynecology program, and a Public Voices Fellow with The OpEd Project.