Contraception as Contraception, a Novel Idea.

I have read a lot in the last couple of weeks about how we need to stop arguing that birth control should be covered by insurance because of its off-label uses. Many people are upset because they see this argument as implying that contraception such as the pill is not valid for its pregnancy preventing properties, but is only valid as a treatment for off-label uses such as regularizing periods and reducing cramps, PMS and heavy flows.

There is a problem with both sides of this.

On one side, constantly arguing that contraception should be covered by insurance for things like heavy menstrual bleeding, debilitating cramping or other non-contraceptive uses does seem to imply that contraception for contraception’s sake are not important enough to be covered by insurance. Nevertheless, I do not think that’s the purpose of bringing up these “off-label” uses (though for some it may be)*. From my perspective, it seems we should be using off-label purposes as fuel for the pro- side of the argument.

We can say if it’s not enough for you to cover contraception for contraception’s sake, then cover it for the sake of contraception and all these other benefits.

On the other side, we do need to argue more in favor of contraception for the sake of contraception as a valid reason to cover birth control. The use of contraception to prevent pregnancy is a valid medical use, and it is one that should be covered by insurance. Pregnancy, as we know from modern medicine, is optimal at certain ages for women. It is safest at certain ages. It goes most smoothly when women are prepared to have a pregnancy, so the choice to prevent pregnancy via contraception is a valid medical decision.

Forget for a moment that access to contraception contributes to women’s equality. It does, but that argument will hardly work on the naysayers.

Contraception should be covered by insurance because planning pregnancy (and therefore planning when you will not be pregnant) is a valid medical decision. To choose when you have the best chance of becoming pregnant, when your baby has the best chance of being healthy, when you are in the best mental and physical state for pregnancy, when you, the woman, are least likely to have complications – all of that is completely valid.

*Some people are stuck with a sort of “sex is bad” view. I feel pity for those people, but Rome wasn’t built in a day and it will take more than a day to make our society more comfortable with sex-positive views. The off-label reasons for prescribing birth control are also valid reasons for why it should be covered by insurance, and I do not think that the vehemence of the defense of these uses is detrimental to the overall point – contraception should be covered by insurance. It kind of surprises me, given the costs of pregnancy and early childhood, that insurance companies didn’t voluntarily adopt prescription contraceptive coverage.

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