Previously published in the Winnipeg Free Press, March 14, 2022
Birth control and access to contraception should be available at no charge to improve reproductive health and save public spending. The federal government is dragging its heels on a national Pharmacare program and Manitobans cannot wait any longer for free access to contraception.
The Manitoba government should implement no-cost contraception. An IUD in Manitoba can cost $380, while birth control pills can cost up to $20 a month and hormone injections $180 a year. How is a student working a minimum wage job supposed to afford this? How will they afford contraception without money? Contraception is expensive for someone living paycheck to paycheck and struggling to pay for groceries. What about a 15-year-old who wants to go on birth control, but their parents disapprove? It has been shown that price remains the most significant barrier to accessing contraception.
Many other countries already subsidize universal access to contraception, in full or in part; these include the UK, France, Spain, Sweden, Denmark, the Netherlands, Italy and Germany.
No-cost contraception allows menstruating people to choose whether or when they have children. This grants them greater control over their bodies, lives and future and respects their ability to pick the contraception that best fits their needs.
Free contraception is a good fiscal policy with numerous health and socio-economic benefits. An unintended pregnancy can be costly to the public system in many ways: pregnancy is a medically risky event. Some women have medical conditions made worse by pregnancy and require birth control. For example, those with polycystic ovarian syndrome or endometriosis may require contraception to subdue symptoms related to their conditions.
Unplanned pregnancies cost the healthcare system $320 million a year in Canada, and research has shown that an increase in IUD use could decrease these costs by over $35 million. Studies in the US have shown that for every $1 invested in contraception, $7 is saved in future healthcare costs.
Manitoba has some of the highest rates of teen pregnancy in Canada. Colorado had a 54% decrease in teen pregnancies, a 64% decline in teen abortion rates, and savings of up to $70 million after providing free IUDs to teenagers. Along with cost savings, there are numerous societal and health benefits.
Access to contraception allows women to plan and manage their lives. Mothers who had access to no-cost contraception were four times more likely to wait an ideal amount of time before their next pregnancy. Pregnancies spaced close together can increase the risk of poor health outcomes for both mothers and infants. Adolescent parenting is associated with lower lifetime educational achievement, low income and increased reliance on social support programs. Access to free contraception helps to prevent teen pregnancies.
Pregnancies that end in abortion or miscarriage are still more expensive to the health system and they carry higher health risks than contraception. “Broad consensus exists among experts, including the World Health Organization, the American College of Obstetricians and Gynecologists and the Society of Obstetricians and Gynecologists of Canada, that increasing access to contraception is a cost-saving endeavour” writes Dr. Michelle Cohen, assistant professor in Family Medicine at Queen’s University.
The research on no-cost contraception is there and demonstrates the immense benefits. Universal coverage for prescription contraception is a good policy as it helps the most vulnerable people in our communities, reduces gender inequality and improves health outcomes for parents with cost savings in the long term.
Manitoba would benefit greatly from the implementation of no-cost contraception.