opinion

Iowa is becoming a contraceptive desert

The U.S. Food and Drug Administration approved the first birth control pill in 1957 — to treat menstrual disorders. Not surprisingly, many women trying to avoid pregnancy suddenly reported being plagued with such disorders. Doctors winked, nodded and wrote a prescription.

Flash forward to Iowa more than 60 years later. We have not come such a long way, baby.

Women in this state may still feel compelled to fabricate a story to obtain contraception. Practitioners at Mercy Health Network’s family practice clinics prescribe “oral hormone therapy” only for medical issues, not to prevent pregnancy.

That is troubling in 21st-century America. Also troubling are meddling politicians who seem to want all women to be pregnant.

Last legislative session, the GOP-controlled Iowa Legislature forced the state to forfeit federal family planning money dedicated to, among other things, helping to cover the cost of birth control for uninsured women. Lawmakers directed the Iowa Department of Human Services to create a new program with state dollars that bars participation by any health provider that also happens to offer abortions.

The result: Planned Parenthood has closed clinics in Bettendorf, Burlington, Keokuk and Sioux City. These four locations, which collectively served about 15,000 patients, specialized in helping prevent unplanned pregnancies by providing women access to a wide range of birth control methods.

Not anymore.

The new family planning program also bars participation of hospitals and clinics affiliated with UnityPoint and the University of Iowa. They provided birth control under the federally funded program, too.

Not anymore.

Add to that the loss of health services caused by the privatization of Medicaid, imposed on the state by former Gov. Terry Branstad and supported by Gov. Kim Reynolds. Among the providers who closed their doors due to payment problems with private insurers were family planning clinics in Grinnell and Marshalltown. Neither provided abortions, but they did provide health services, including birth control, to about 2,000 patients.

Not anymore.

Iowa, it seems, is on its way to becoming a contraceptive desert.

Limiting access to birth control will lead to more unintended pregnancies, more women not obtaining prenatal care and more women seeking abortions. That is not what anyone, regardless of political or religious affiliation, should want.

Iowans have the power to change this course.

They can voice their disapproval to and no longer patronize health systems that allow supposed piety to dictate prescribing policies.

They can donate money to organizations like Planned Parenthood and visit those clinics for their own health care.

They can vote for state legislative and gubernatorial candidates who truly respect women.

And they can pester officials in Washington, D.C.

The situation in Iowa underscores the need for the U.S. Food and Drug Administration to finally make birth control available without a prescription. Women in countries all over the world can obtain pills, which are essentially hormones the body produces, without scheduling a doctor’s appointment.

In the United States, politics have taken precedence over common sense.

Birth control pills are proven to be safe, effective and easy to use. An Iowa woman should be able to buy them without a prescription at a drugstore — the same way she can buy Claritin for allergies, Zantac for heartburn and more than 700 other over-the-counter drugs that previously required a prescription.

The FDA, working with panels of outside experts, has determined hundreds of drugs can be used without a doctor’s supervision.

Birth control pills should be added to the list.

In 2010, 23,000 Iowa residents experienced an unintended pregnancy, according to the Guttmacher Institute, which collects reproductive data. Those pregnancies cost the state and federal governments about $176 million. In 2011, there were 4,080 pregnancies among Iowa teens.

Even women who want to have children spend the vast majority of their reproductive years trying to avoid getting pregnant. They do this by using birth control. Yet GOP leaders are bending over backward to make it more difficult to obtain.

The same politicians who blather on about “personal responsibility” are impeding the ability of Iowans to make responsible reproductive choices.

Costs of contraception

Health insurance frequently helps cover the cost of contraception. Women without insurance who do not qualify for financial assistance must consider the cost of birth control in their decision about what method to use. Planned Parenthood of the Heartland provided the Register editorial board with charges for some common forms of birth control.

Birth control pills: A method that uses hormones (estrogen and progestin) to prevent pregnancy. Users take one pill a day. Cost: $42 per month, or $504 per year

IUDs: A T-shaped device, which in some cases also contains hormones, placed in the uterus by a healthcare provider. It is effective for several years. Cost: $858 to $1,000, plus $230 insertion fee.

Shot (Depo-Provera): A hormone injection every three months. Cost: $150, plus $49 injection fee.

Implants: A hormone-releasing device about the size of a matchstick, inserted in the upper arm and effective up to four years. Cost: $900, plus insertion fee of $253.

Crocodile dung does not prevent pregnancy

Long before humans understood anything about the universe, they were trying everything under the sun to prevent pregnancies. A cave painting in France believed to be 15,000 years old depicts what some researchers think is the first illustration of a man wearing a condom.

In ancient Egypt, women would mix substances including crocodile dung to use as what was certainly an ineffective spermicide. Concubines in ancient China were thought to have used drinks containing lead and mercury. Women were advised to do everything from holding their breath to tying weasel testicles around their neck during intercourse to prevent pregnancy.

In 1861, the first advertisement for a condom showed up in the New York Times.

Nearly 100 years later, chemist Carl Djerassi synthesized hormones from yams. The scientific race for a birth control pill was on — with help from a wealthy women’s rights activist — to develop and test progesterone in women.

The U.S. Food and Drug Administration approved the first birth control pill to treat severe menstrual disorders in 1957. Three years later, the pill was approved for contraception. In 1988, the original pill was taken off the market, after an FDA study showed the health benefits of newer pills, including a decreased risk of ovarian cancer. In 1997, the FDA approved a birth control pill to treat acne.

This editorial is the opinion of The Des Moines Register’s editorial board: David Chivers, president; Carol Hunter, executive editor; Lynn Hicks, opinion editor; and Andie Dominick, editorial writer.