Essay by Jessica Grossman, the CEO of Medicines360 and an obstetrician-gynecologist.

By now, many will have heard the Trump Administration has issued two new rules that would let any employer decline to provide contraception coverage to their employees, based on a sincerely held religious or moral conviction. It would also allow insurers to refuse to cover contraception in the same way.

The tough reality is that these rules could quickly and seriously decrease many women’s access to contraception, and over time put access on the line for millions more women.

Advocates and activists have taken immediate action to counter these rules. Lawsuits have been filed, petitions circulated, grassroots campaigns organized — and more. I’ve been grappling, as I’m sure many have, with the question: what’s the most effective role I can play in this fight?

As an obstetrician-gynecologist, an advocate for women’s health, and the CEO of Medicines360, a nonprofit pharmaceutical company that makes our hormonal IUD available through safety-net clinics, I want to draw attention to two hidden consequences of these rules.

1. Limiting the contraceptive choices available to women detracts from the doctor-patient relationship

It could push women and their doctors to base their contraceptive decisions on factors that shouldn’t be involved, like how much medicines cost. It’s important to ensure women’s care decisions are patient-centric and based on clinical concerns first and foremost, including sound evidence, careful weighing of the benefits of medicines for patients, and other factors that are best handled between women and their doctors.

2. What really helps prevent unintended pregnancy isn’t just access to one form of contraception: it’s access to the full range of contraception

That’s where these rules could have a troubling impact. We all want to know that medical guidelines are based on the best possible evidence, right? Well, we know two things based on years of accumulated research data: while approximately half of American pregnancies are unintended, greater access to the full range of contraceptive options has helped reduce this rate.

It’s counterproductive to pull back access and risk the gains we’ve made towards women living their best and fullest lives. Access to contraception and family planning counseling supports appropriate birth spacing, which in turn helps improve health outcomes for women and infants. The costs of a backslide in unplanned pregnancy rates would be profound: our health system would be forced to bear more financial costs, while children, women, families and communities would become less secure.

Access to contraception helps women attain higher levels of education, more economic success and healthier families.

For young adults, even modest increases in the availability of contraception leads to significant and lasting educational and employment gains for women.

My colleagues and I work hard to provide affordable, quality care to all women that’s based on solid evidence — and so do many of our peers. These rules introduce factors into care that simply don’t belong there. Contraception plays an essential role in all our lives, so let’s agree to help all women access the tools they need to plan the lives they want.

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