I firmly believe that all women should have access to accurate information and comprehensive reproductive health care. I have expressed this point of view in my writing about the HHS ruling and have received a great deal of support and some opposition. The opposition is from men and women who argue that women should “keep their legs closed” or pay for birth control themselves. Well… it takes two to tango and quite frankly I don’t want to keep my legs closed with my husband, thank you very much! I also don’t want to get pregnant after having two kids. And, when it comes to payment…I do pay, that’s called health insurance.
The Trump/Pence Administration has formalized this judgement of women, declaring in their HHS ruling that covering all contraceptive methods with no out-of-pocket costs, as was previous done under the Affordable Care Act, increases risky sexual behavior among “some populations”. This claim has been debunk by leading scientists and healthcare providers, not to mention it’s incredibly discriminatory. It also ignores the reality that a large population of American women are forced to have unprotected sex by an abusive partner.
It’s ironic (and disturbing) that the HHS ruling came out in October, which is Domestic Violence Awareness Month. For most people, the terms domestic violence or Intimate Partner Violence (IPV), conjure images of physical violence. Certainly, abusive partners use physical violence to control their partner, but they also use a variety of other methods of control. These include emotional, technological, or financial control, and many abusive partners exert reproductive and sexual control.
Reproductive and sexual control is actually quite common–nearly 75% of women with a history of IPV report male reproductive control. Reproductive and sexual control involves explicit attempts to impregnate a partner against her will, control the outcomes of a partner’s pregnancy, coerce a partner to have unprotected sex, or interfere with a partner’s contraceptive methods.
For some abusive men, having a child with a partner is a way to keep her inside of the relationship. Some men equate birth control with promiscuity and so will sabotage their partner’s use of contraception in anger or as a power play. Some abusive men participate in “stealthing,” the practice of removing a condom during sex without a partner’s knowledge or consent. And still, other men simply don’t like the feel of a condom and coerce their partner into unprotected sex with threats of breakup, threats of infidelity, or guilt, embarrassment, and violence.
Ensuring women have access to the full range of birth control options is an important way to protect women who are experiencing reproductive and sexual control at the hands of an abusive partner. In fact, the American College of Obstetricians and Gynecologists (ACOG) recommends that healthcare providers consider a number of harm-reduction strategies with their patients. These may include giving a patient a plain envelope for any emergency contraception or birth control pills to avoid an abusive partner discovering it or discussing the use of a copper IUD over birth control to provide long-term protection. If a patient should choose to use an IUD, both ACOG and Futures Without Violence recommend that healthcare providers consider trimming the IUD strings to avoid detection by the abusive partner.
It can be hard for people who haven’t experienced IPV, either personally or with a friend or family member, to hear that women must go to such extremes to protect themselves against unintended pregnancy at the hands of an intimate partner. For those who have lived through an abusive relationship—nearly 1 in 4 women in the United States, sexual and reproductive control is all too familiar.
The Trump/Pence Administration HHS Rule has the potential to severely limit which methods of birth control a woman has access to and, as we are beginning to see, whether or not she has any access to birth control at all. For those experiencing sexual and reproductive control, this rule gives their abusive partner the upper hand. Women experiencing IPV need greater access to birth control, not less. If this rule were truly about morality, it would recognize this.
In Trump & Pence’s new republic of Gilead morality is being used as a cover for profit and control over women. We must stand up, speak out, and #Resist.