Opinion | Expand access to birth control

Expanding access to birth control would result in positive outcomes for women in Iowa.

Sophie Stover, Opinions Columnist


Iowa women have called for expanded access to birth control, but Iowa legislators didn’t respond until 2019. The Iowa General Assembly threw away the opportunity to make contraceptives available without a prescription two years ago, so the chance arises again this session. Iowa lawmakers need to pass the bill this session because it would be a huge win for women.

Under HF 434, self-administered hormonal contraceptives would be available without a doctor’s prescription to people aged 18 or older. Types of birth control included in the legislation are vaginal rings, the patch, and pills. If enacted, the bill would not make contraceptives over the counter medications, but rather still covered by insurance.

All women must have access to adequate reproductive health care. Reproductive health as a broader category is multi-faceted, including the right to an abortion, STI screening and treatment, and access to birth control. Increasing access to birth control is an important step in strengthening reproductive health care for women in Iowa.

According to Power to Decide, an advocacy group working to prevent unplanned pregnancies, around 173,100 women live in contraceptive deserts in Iowa. A contraceptive desert, by their definition, is a county in which there is not reasonable access to health centers that offer a full range of contraceptive methods.

This means that women living in an area without adequate access to birth control are unnecessarily burdened by long drives for health care.

If the requirement of attending a doctor’s appointment is removed, thousands of women living in Iowa’s contraceptive deserts could obtain birth control they may have otherwise not been able to access. Expanding access to birth control is a pertinent issue, and the implications will manifest in multiple ways.

By going straight to the pharmacy, women are able to avoid expenses incurred by repeated visits to a doctor. Many women may have to take time off school or work, which could be avoided with passage of this bill. Weighing the opportunity cost of going to a doctor for contraceptives at the expense of missing an obligation is a predicament no woman should endure.

In addition to lowering the cost burden, expanding access to contraceptives would produce long-term health benefits for many women. The birth control pill boasts a variety of potential positive health effects. It can prevent or alleviate the negative effects of cysts, cancers, or serious infections, in addition to mitigating the uncomfortable byproducts of a monthly period.

Finally, more women having access to safe birth control will result in less unintended pregnancies. The Brookings Institution, a U.S. based research group, has studied past state initiatives that resulted in declining unintended pregnancies. Increasing availability to contraceptives was integral to these efforts.

Anti-abortion advocates argue that expanded access to birth control would be unsafe, possibly resulting in induced abortions. Subsection 44a of the bill clearly states that abortion inducing drugs are not included under the provision. If the goal is to lower the rates of unintended pregnancies and abortions, the best course of action is providing an easier pathway to birth control.

The bill, originally proposed by Iowa Gov. Kim Reynolds, had bipartisan support in 2019. The initiative still has support from both parties two years later. A renewed opportunity to improve women’s health in Iowa should not be squandered.


Columns reflect the opinions of the authors and are not necessarily those of the Editorial Board, The Daily Iowan, or other organizations in which the author may be involved.