1. Freda, Margaret Comerford EdD, RN, CHES, FAAN

Article Content

Throughout my adult life I have relied on dependable contraception, as I'm sure most of you have. This is practically a universal experience. I started using it when I got married in 1967. But this editorial isn't about me, or even about your contraceptive needs. This is about what we do for our patients. All of us need to be concerned about birth control, no matter our religious persuasion or ethnic makeup, for we are nurses, and it's our job to help women learn what they need to know about making the best choices about when to conceive. Childbirth by choice, using natural methods, barrier methods, or hormonal methods, is the right of all women on earth. No woman can live a healthy life and conceive every time she ovulates. We all know that. Yet, there remains a stigma in some circles about birth control, and some women, including teenagers, are ashamed to admit they need it. This stigma has remained so strong that birth control has, in the United States, been difficult for women to obtain in many ways: (1) because all methods except barrier methods have traditionally required a healthcare visit (a costly event for those with little funds); and (2) even for women with health insurance, contraception has not been covered. This has always infuriated me. I don't mean to be sexist here, but do you know that Viagra is covered by insurance for men? Has there been some sort of male preference going on? Helping men to increase their sexuality seems to appeal to insurance companies, whereas helping women to choose when they desire a pregnancy apparently does not.


Fast forward to August 2, 2011. The New York Times put it this way: "The Obama administration issued new standards on Monday that require health insurance plans to cover all government-approved contraceptives for women, without co-payments or other charges." This coverage goes into effect ( depending on the insurance company) between August 2012 and January 2013.


And there's more good news. It's not just contraception that will be covered, but other preventive services as well such as mammograns. The new law bans copayments, deductibles, and other charges also, all in the service of getting preventive services to women. All contraceptive methods approved by the FDA must be covered under this law, including the noncontroversial as well as the controversial (such as emergency contraception Plan B). There are religious groups that decry this new law, as is their right, and there is certainly no mandate to use contraception. But this new law finally-finally-makes contraception for those women who want and need it available, with no barrier such as finances or copayments. The law also includes requirements for health plans to pay for domestic abuse screening, HIV testing, and counseling for breastfeeding. Amazing!! I've been waiting for these types of healthcare services to be available free to women for my entire career, and it has finally happened. The public health community-those people who believe that we are all in this life together, and what helps one person ultimately helps us all-are rejoicing at this news. This is big. This could change women's lives. It only took 45 years of my career for my children and grandchildren to be able to avail themselves of preventive care without barriers. How far we've come!!