Early in my career as a nurse practitioner and midwife, I went to a conference where I heard the term “Reproductive Life Plan.” In this conference we were encouraged to use this term with women at any and every opportunity for screening and counseling. Not just when women came in for sexually transmitted infection screening or birth control, but also during annual exams and routine wellness visits. I did begin to implement this practice… and guess what I learned?
I learned that almost every woman had a plan; a clear plan of her hopes and dreams for if, how and when parenting would enter her life. These plans are ones I, as a women’s health practitioner, want to support. I want to have the tools to help my patients follow these plans because, after all, many women spend only roughly three of their fertile years wanting to be or being pregnant, compared to three decades of their fertile years trying to prevent pregnancies.
So what are we actually seeing? In the U.S., recent data has suggested that almost 50 percent of pregnancies were, in fact, unintended – not part of the reproductive life plan.
This high rate of unintended pregnancies comes with serious personal, family and societal consequences. Births resulting from unintended or closely spaced pregnancies are associated with adverse maternal and child health outcomes, such as delayed prenatal care, premature birth, and negative physical and mental health effects for both parents and children. Unintended pregnancies also lead to disruptions in women’s education, career advancement, and earning power that impact their families and our whole economy.
In New Hampshire, our data is comparatively better – we have one of the lowest unplanned pregnancy rate in the country at 43 percent – but that still leaves a lot of room for improvement.
Why are our rates of unplanned pregnancy still so high? I believe barriers to accessing safe, reliable birth control are a major factor. And one of those barriers comes from the fact that most insurance coverage for birth control in New Hampshire currently provides for a month-to-month supply of contraception, requiring even women who know they want to prevent pregnancy for years to come to make a monthly trek to a pharmacy to refill their prescription. This is not common sense.
Our state lawmakers have an opportunity to dismantle that barrier this year and take a step forward for women and their families. There is a bill, SB 421, that would enhance New Hampshire’s “Contraceptive Equity Law” to reflect current coverage and medical best practices by retaining the no co-pay protections already in the law and by adding a requirement that coverage include a 12-month supply of prescribed, self-administered, contraception at each dispensing interval.
SB 421 is set to come before the Senate Commerce Committee on Feb. 20. It’s a bipartisan New Hampshire solution to ensure women have access to birth control at a time when we are seeing a rise in unnecessary and antiquated attacks on contraceptive access. Planned Parenthood New Hampshire Action Fund, the American College of Obstetricians and Gynecologists, the New Hampshire Nurses Association, New Futures, Bi-State Primary Care, the New Hampshire Women’s Foundation, the Equality Health Center, the Joan G Lovering Health Center, ACLU - NH, the YWCA of New Hampshire and the NH Public Health Association all support this important bill.
Our state senator, Andy Sanborn, will have the opportunity to weigh in first on this bill, since he sits on the committee that decides how to recommend SB 421 to the full Senate. I encourage him, and all of our local state representatives, to support this common sense proposal to expand access to birth control and help women and families across New Hampshire plan their futures and pursue their dreams.
Sarah Bay, MN, APRN, CNM, is a nurse practitioner and midwife who practices in Peterborough.