Roughly one in four teen girls become pregnant at least once by age 20 and fully half of all pregnancies in the United States are reported by women themselves as unplanned. Not too good.

By posting some intemperate thoughts about sex, love, relationships, pregnancy, childbearing, the media, public policy, our dogs, and other topics, we hope to spark a two-way discussion about how best to bring down the high rates of teen and unplanned pregnancy in this country. And who knows…from time to time, we might even offer up a few cogent thoughts that will be helpful.

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April 05, 2017

By Jane Haines, National Campaign Intern

We’ve said it before and we’ll say it again: birth control is popular. With everything happening in Congress lately, it can be easy to forget that more than 80% of people in the United States agree that contraception is a basic part of women’s health care, including Democrats and Republicans alike.

Two weeks ago marked the seventh anniversary of the signing of the Affordable Care Act (ACA) that gave 55 million women access to no-cost preventive services, including birth control. This legislation was an important step towards ensuring every person has the power to decide if, when, and under what circumstances they become pregnant.

I was just 14 years old when the ACA became law, and a lot has changed since then. Prior to the ACA, women using birth control could spend between 30 and 44 percent of their total health care spending on contraceptives. Thanks to the no-cost birth control provision, I’ve never even had to think about my wallet when deciding which method is right for me. In fact, I’m part of an entire generation of women who have never known what it’s like to pay a dime in out-of-pocket costs for birth control.

Meenal, 21, from New Hampshire says that as a low-income student, she wouldn’t be able to afford birth control without the Affordable Care Act. “I use it for a hormonal issue that otherwise causes me to miss multiple days of work and school each month and has severe detriments to my health.”

For women of my generation, no-cost birth control isn’t just a policy, it’s a normal part of life.

Like me, Becca, age 21, from Virginia was 14 when the ACA was passed. She says, “I was missing so much school due to my irregular and unbearable periods. When the ACA made my expensive [birth control] prescription free, it was one less thing my family had to worry about.”

Since then, she’s tried just about every method to manage debilitating cramps, acne, and ovarian cysts. When Becca entered a serious relationship in college, she sought an easier, more effective option than the pill. “The ACA allowed me to go from thinking about an IUD to having one [inserted] in under a week. There was no confusion with my HMO, no financial burden. Words cannot describe how grateful I am for that.”

Prior to the ACA, an IUD could cost as much as one month’s salary for a woman working full-time at the federal minimum wage. Sarah, 22, from Arizona said she took the plunge to get an IUD only after she found out it was 100% covered by her insurance.

“My pay puts me barely above the poverty line and I knew that contraception without coverage would set me back badly in the future. I was nervous about the cost, but thanks to the ACA, my balance was $0.00.”

Still, some women haven’t been so lucky. Ella, 20, from Ohio primarily takes birth control to treat the symptoms of endometriosis. Even though the pill served double duty after she became sexually active, Ella says, “I had a $50 per month co-pay for a pill called Lo Loestrin, not exactly affordable for a college student.” While she’s still searching for a method that will successfully manage her symptoms, Ella continues to discuss the implant and IUD with her doctor as long-acting, low cost options that could help her avoid the monthly copay. Thanks to the ACA, prohibitive costs are no longer a part of that conversation.

For women like Meenal, Sarah, Becca, Ella, and myself, a lot can change in seven years, but no-cost birth control doesn’t have to. Women using long-acting, reversible contraceptives (LARCs) have experienced close to a 70% decline in out-of-pocket costs since the ACA, and we can’t afford to lose coverage now. Removing the no-cost contraceptive provision would disrupt the lives of millions of women—women my age and otherwise—who rely on birth control to help them decide if, when, and under what circumstances they become pregnant.  While the ACA remains intact for now, we can’t take it for granted. We’ll keep working to make sure the future of birth control stays available, accessible, and as low or no cost as possible.

For more stories about how birth control has made a difference in peoples’ lives across the country, keep reading the Chronicles of Contraceptive Access and visit our storytelling portal.

(Editor’s note: submissions have been edited for clarity and length).

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March 29, 2017
Authored by: Rachel Fey

Rachel Fey is the Director of Public Policy at The National Campaign where she is responsible for the organization’s health policy work, including implementation of the Affordable Care Act, Medicaid family planning, and the Title X Family Planning Program. She also focuses on health disparities and budget and appropriations, specifically funding for teen pregnancy prevention programs and public funding for family planning.

Prior to joining The National Campaign, Ms. Fey was Manager of Government Relations at the National Family Planning and Reproductive Health Association (NFPRHA) where she worked on key provisions of the Affordable Care Act and the Medicaid and Title X Family Planning programs. Recognized in 2013 by the Professional Women in Advocacy Conference as an Up and Coming Practitioner, Ms. Fey has over a decade’s experience working in the field of non-profit reproductive health, including for the Association of Reproductive Health Professionals (ARHP) and the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs.

Ms. Fey holds a BA in International Studies from the Johns Hopkins University.  She lives in Washington, DC and stamps her passport as often as possible.

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Authored by: Ginny Ehrlich

Ginny Ehrlich is the chief executive officer at the National Campaign to Prevent Teen and Unplanned Pregnancy. Prior to taking the helm at the National Campaign, Ginny directed the childhood obesity prevention portfolio at the Robert Wood Johnson Foundation, and led the Foundation’s efforts to establish a strategic direction for its $500 million investment in ensuring that all children achieve a healthy weight by 2025. Previously, Ginny spent eight years at the Clinton Foundation, where she served as the Founding CEO of the Clinton Health Matters Initiative and the long-time CEO of the Alliance for a Healthier Generation. During her tenure at the Alliance for a Healthier Generation, Ginny positioned the organization as a national leader on preventing childhood obesity and started the nation’s largest school-based obesity prevention program. Ginny started her career in the classroom as a health and sexuality educator, and has held several state and national leadership positions.

Ginny has dedicated her more than 20-year career to improving the health and wellbeing of children, adolescents, and families. Known for her abilities to build organizational strategic vision and foster partnerships of great purpose across the public, private and nonprofit sectors, Ginny was recognized in 2012 by Health Leaders as one of the nation’s top change agents in the health sector. Ginny has a breadth of experience working with businesses, community organizations, policymakers, schools, and government officials on a wide variety of social welfare issues.

Ginny holds a doctorate of education in education leadership and a Master of Science in Special Education, both from the University of Oregon, a Master of Public Health from Boston University and a BA in Community Health Education, from the University of Oregon. She lives in Washington, DC; she is an avid tennis player and runner.

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A group of teenage girls