Mind and Body
Election 2016: Study Links Trump's Presidency to Spike in Birth Control
After Donald Trump was elected president, women around the US feared that the new administration would hinder their access to contraceptives. As a result, many announced they would get long-term birth control before it was too late. New research proves that these women kept their word.
A study published Monday in JAMA Internal Medicine shows that soon after the 2016 presidential election, there was a spike in insertions of long-acting reversible contraceptives, a group that includes implants and intrauterine devices (IUDs).
The study, which focused on commercially insured women between the ages of 18 and 45, examined how many of these women received long-acting reversible contraceptives (LARC) in the 30 business days before and after the election. The researchers then compared this data to the 30 days before and after November 8, 2015. This comparison helped them establish what the LARC insertion rates were in a “normal” year. Overall, they found a 21.6-percent increase in the insertion rates of LARC methods in the 30 days after Trump was elected.
They write that if these findings were projected to the approximately 33 million women in the United States in this age group in 2016 with employer-sponsored health insurance, this rates corresponds to 700 additional insertions per day linked to the election. That translates to an additional 21,000 implants and IUDs.
“I think that the magnitude of the effect we found is quite impressive,” lead author Lydia Pace, M.D., tells Inverse.
Pace, an assistant professor of medicine at Harvard Medical School, says that, like many people, she and her team had heard reports of health organizations and providers experiencing an uptick in women seeking IUDs after the 2016 election. They wanted to see, when you statistically account for pre-existing trends in the use of LARC methods, whether the post-election bump was real.
“To me, the results suggest that women’s contraceptive decision-making and choices are, or can be, influenced by political events and further, that privately insured women value contraceptive coverage,” Pace says.
This, she argues, is an important message for the public and for policymakers. Pace believes it is fair to say that women should be concerned about losing contraceptive coverage in today’s political environment, citing that there’s been “several recent national policies that threaten both privately and publicly insured women’s access to comprehensive reproductive care, including contraception.”
In 2012, the Affordable Care Act eliminated cost-sharing for contraception for most women with private health insurance. As a result, by 2013, most women didn’t have out-of-pocket expenses for contraception, and median expenses for most contraceptive methods, including the pill and the IUD, dropped to zero. Previously, the high cost of long-acting methods like the IUD and the implant had been a significant barrier for many women.
In addition to being longer-acting, IUDs and implants are often more effective, too — women who use birth control pills, the patch, or a vaginal ring are 20 times more likely to have an unintended pregnancy than women who use an IUD or implant.
The Trump administration attempted to amend the ACA in 2017 with a new policy that would allow employers to exercise their “conscience rights” — employers could opt out of paying for workers’ contraception if they have religious or moral objections to birth control. This January, two federal judges successfully blocked this rule, but experts don’t think the defeat will keep the administration from similar moves in the future.
The study is limited in that it only examined women with commercial insurance, and the women who received the contraceptives weren’t asked why they made the decision. Pace and her colleagues write that the findings could reflect a “a response to fears of losing contraceptive coverage because of President Trump’s opposition to the ACA or an an association of the 2016 election with reproductive intentions or LARC awareness.”
Planned Parenthood employees, meanwhile, corroborate the idea that the election prompted an uptick in insertions. A spokesperson told CNBC that there was “a nearly tenfold increase in appointments for IUDs in the first week after the election” and that they “also saw an unprecedented surge in questions about access to health care and birth control, both online and in our health centers.”
Pace notes that there is no “ideal” rate for the use of LARC methods, but that rates of LARC use in the United States are still lower than many other countries. And while our rates are on the rise, not everyone can easily access a LARC method. Myths and misunderstandings about IUDS, spread both by doctors and patients, have affected their adoption, and even the option to have one is far from ubiquitous across the states.
“In an ideal universe,” Pace says, “all women would have access to whatever contraceptive method makes the most sense in light of her preferences and goals.”