The Coming Fight Over Paying for the Pill

Advocates for reproductive rights are bracing for a battle with social conservatives as they push to make health insurers offer contraceptives for free.

By Michelle Chen Jul 08, 2010

Just when you thought we were finally done with the right-wing freakout masquerading as a national healthcare debate, we may be in for another culture war. This time, the "controversy" would be less about whether your tax dollars will be lavished on evil abortion doctors, but, remarkably, whether helping women prevent unwanted pregnancy is a good thing.

For half a century, one little pill has given women unprecedented power over their reproductive destinies, and in turn reshaped their economic and educational opportunities. Not surprisingly, that doesn’t sit well with policymakers who long for simpler times, when baby-making was the only full-time job that mattered for half the population. Now, advocates for reproductive rights are bracing for a battle with social conservatives as they push to make health insurers offer contraceptives for free.

Currently, many plans don’t provide comprehensive coverage for the pill or other forms of contraception, forcing women to pay as much as $50 per month in order to avoid unintended pregnancy. Not only does this undermine the goals of family planning and preventive health–which, as Monica Potts points out, even abortion foes should support–it marginalizes the health needs of women and exacerbates the economic gender gap.

Yet one thread that hasn’t been highlighted in the feminist blogosphere is that safe contraception, like abortion, is an especially fraught issue for women of color, whose choices are often further limited by racial and economic barriers. Indeed, the reproductive justice movement evolved out of a long struggle to develop a race-conscious feminist analysis of gender, family, community and motherhood.

As activist and academic Dorothy Roberts wrote in 2000, the pill was a watershed for all women, but Black women in particular came to see it as a tool for strengthening their power of choice:

For nearly a century, black women have found themselves at the center of controversies about birth control’s role in the struggle for racial and sexual equality. They have battled not only men–white and black–who discounted the importance of women’s bodily autonomy, but also white women who discounted the significance of racism. The dominant women’s movement has focused myopically on abortion rights at the expense of other aspects of reproductive freedom, including the right to bear children, and has misunderstood criticism of coercive birth control policies. Attending to black women’s perspective on the pill and other contraceptives can help to transform the movement for reproductive freedom. It can help us understand that there is nothing contradictory about advocating women’s freedom to use birth control while opposing abusive birth control practices. Social justice requires both equal access to safe, user-controlled contraceptives and an end to the use of birth control as a means of population control.

At a time when Black women were regularly shamed and dehumanized by racist stereotypes about so-called welfare mothers and Black fertility, a medical innovation that could liberate sex from procreation was a major step toward realizing the full spectrum of human rights. The fight for health sovereignty continues today, and women of color have more at stake than ever in protecting the reproductive freedom they helped define.