Gynecologist Lilian Schapiro scooted up to her patient, who was already in stirrups on the exam chair. Her patient was a mother of two in her early 40s. She was seeing Schapiro to get her IUD replaced.
“I-U-D stands for intrauterine device,” Schapiro said. “A speculum is put in, it [the IUD] goes through the cervix and stays inside the uterus.”
It’s a form of long-lasting birth control, and depending on the type, can last anywhere from three to 10 years. They can cost up to $1,000 out of pocket.
Health care providers like Schapiro say they’ve seen an increased demand for birth control since Donald Trump was elected president. She said a bulk of her patients fear the new administration could end coverage for contraception. Nationally, Planned Parenthood has reported a 900 percent increase in women trying to get long-acting forms of birth control.
Schapiro’s patient, who asked that we not use her name, has been using a six-year device called Mirena.
“Had my children. And then in between each child, I had a Mirena because it was very simple,” the patient said. “I didn’t have to worry about it. I breastfed and ran around and took care of the baby and didn’t have to worry about taking the pill every day.”
She went in partly because It was just time to get her IUD replaced, but there was another reason she came now.
“When you talk about how things have changed or may change with health care, I’m a little nervous,” she said. “So I thought I need to get it done now, and that way I don’t have to worry about it.”
Schapiro said this concern is something she’s hearing from many patients in the lead up to Donald Trump becoming president.
“I just have my own personal anecdotal experience of 20 years compared to what I did last Saturday,” Schapiro said. “In the past, I have put in, I would say, one to two IUDs a month, and I put in four on Saturday.”
She’s had her office open for longer hours since the holidays just to deal with demand.
Right now, under the Affordable Care Act, there’s no copay for any FDA-approved contraception. That’s anything from birth control pills to IUDs. Schapiro said the patients she sees are very aware that access may be about to take a hit.
“Trump has talked about repealing the ACA, which put the birth control benefit into place,” said Gretchen Borchelt, vice president for reproductive rights and health at the National Women’s Law Center, a group that advocates for women’s reproductive health care rights.
“And we know that there are members of Congress who’ve made this a top priority, and the process has already been started in Congress,” she added. “So they’re taking their first steps right now through the budget process to repeal the ACA.”
Planned Parenthood, which is a major source for birth control services, is also a target. Vice President-elect Mike Pence has been a leader in the effort to defund the organization. Borchelt said, so far, the plans lawmakers have proposed to replace the ACA haven’t included protections for women’s preventive care, which includes things like breastfeeding support and well-women visits, in addition to contraception.
Not everyone is so worried about these potential changes.
“When it comes to IUDs and birth control, we’ve never believed free access to those is good for women,” said Emily Matson, executive director of Georgia Life Alliance, an anti-abortion advocacy group.
“Overall if there is a limitation to government-funded access to contraception, our hope is that that would move the pendulum back with our young people to be more socially and personally responsible,” she said. “The more contraception that’s available, the more people are having sex, and with that comes unintended consequences.”
Matson’s group and her supporters believe those consequences include people facing the decision to abort an unintended pregnancy.
A 2014 study funded by the National Institute for Health suggests otherwise. Researchers followed more than 9,000 women in St. Louis with access to free birth control and found negligible changes in the amount of sex they were having and the number of partners they had it with.
Additionally, a growing body of research seems to show that increased use of long-acting forms of contraception like IUDs are contributing to fewer people seeking abortions.
Schapiro added another point about who contraception access affects.
“So I think a lot of people picture sexually active women as young teens who perhaps they think should not be sexually active, but contraception is used by women of all ages,” she said.
They include her patient, who had her IUD replaced in about three minutes.
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