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Are All Women in Canada Really Free to Choose?

Author: Kennadie Chaudhary, AccessBC Campaign Coordinator

Access to contraception, as a reproductive right, is a basic human right. However, many Canadians are unable to exercise this right for a variety of reasons. One of these reasons is the significant barrier of cost. People who can get pregnant are disproportionately affected by the often high costs of contraception. These costs can include between $75 and $380 for an intrauterine device (IUD), $20 per month for oral contraceptives, and up to $180 per year for a hormone injection. Lack of coverage for contraception means youth, people with low-income, and those from marginalized communities face a severe disadvantage when making choices about their bodies. Thus, acknowledging the factor of cost is essential to making universal access to contraception a reality. 

There are numerous benefits to accessible contraception, which are evident in studies in North America and around the world. In Canada, the cost of contraception is almost entirely the responsibility of the user, with few exceptions. This is in contrast to several countries which similarly have universal health care, but have chosen to subsidize prescription contraception, either in full or in part. Countries with universal healthcare that subsidize contraception include over 11 members of the European Union, the UK, Australia, and New Zealand. Countries with universal access to prescription contraception have recognized the social and public health benefits of doing so, and their programs are often revenue positive. A 2015 study in the Canadian Association Medical Journal​ estimated that the cost of delivering universal contraception across Canada would be $157 million. Yet, the savings for direct medical costs of unintended pregnancies alone would be approximately $320 million. 

A Colorado program offering free IUDs to young people saw a 54% reduction in teen pregnancies and a 64% decline in teen abortion rates over eight years. The program came to a cost of $28 million, saving the US government an estimated $70 million. In Canada, about 59,000 adolescent pregnancies per year are unintended. Studies such as the Colorado program show the immense impact that access to contraception can have. Unintended pregnancies are expensive and can significantly alter an individual’s life plans. Further, reducing unintended pregnancies and allowing women to properly space births by providing them with access to contraception prevents over 200,000 maternal deaths worldwide each year.

Access to contraception is not only an issue of health. Contraception is also an issue of gender equality. While condoms are often easily accessible at little or no cost and vasectomies are covered under provincial health insurance plans, people with uteruses face significant barriers to autonomous contraception due to cost and requiring a prescription. Advancing gender equality requires recognizing that the costs of prescription contraception should not disproportionately fall on women alone. Women’s right to decide if and when they want to get pregnant should not be based on what they can afford. The ability to make that decision freely will contribute to the status of women, their right to health, and their empowerment as decision-makers.

AccessBC is a province-wide campaign that advocates for universal no-cost prescription contraception in British Columbia. AccessBC is currently running a letter writing campaign to urge the BC Government to include this policy in the upcoming 2021 budget. You can learn more about AccessBC, the need for, and benefits of, making all prescription contraception universally available at no cost, at www.accessbc.org.

Photo by Reproductive Health Supplies Coalition on Unsplash