People have more time for sex these days but fewer options when it comes to protecting themselves against unwanted pregnancy. Women may not be able to get pill renewals, leaving some couples to fall back on condoms, which have a higher pregnancy rate. (One in six couples relying on condoms will get pregnant each year.) Now the United Nations warns that condoms, too, may become hard to get.
It’s a problem of supply chains and international trade restrictions. Malaysia, one of the world’s top producers of rubber and rubbers, has been hit hard by Covid-19, with the highest infection rate in Southeast Asia. Since the government locked down the country, condom factories have been forced to close or reduce production. Karex, which produces a fifth of the world’s condoms, expects to produce 200 million fewer rubbers per month during the peak of the shutdown this spring.
That’s bad news for couples who would rather delay pregnancy in the middle of economic uncertainty or who may be struggling to care for the kids they have already. Ninety percent of unprotected couples get pregnant each year, about half within three months.
As with the pandemic response broadly, much of the hardship and suffering associated with disrupted birth control access could have been avoided by improving medical systems ahead of time. Two changes in particular make a world of difference when it comes to people being able to manage their fertility: over-the-counter birth control pills, and universal barrier-free access to state-of-the-art IUDs and implants.
Free the Pill. There is no medical reason anymore for birth control pills to require a prescription, and in most countries they don’t. Pill access in the United States is made harder than it needs to be by outdated regulations that were put in place back when the pill was less known (and when doses and side effects were higher). Today the pill is safer than familiar over-the-counter medications like Tylenol, including for teens, and the restrictions are, frankly, archaic and paternalistic.
Fortunately, Planned Parenthood has spent several years perfecting telemedicine services. Women in many regions can use Planned Parenthood Direct to schedule a remote appointment and have pills shipped directly to their home. But even this streamlined service isn’t medically necessary; it’s simply a way of women getting what they need under current regulations. A coalition called Free the Pill has launched an all-out effort to bring American pill access into line with most of the world, so that pill purchase is a simple trip to the pharmacy.
Upstream USA. Modern IUDs and contraceptive implants are more than 20 times as effective as the pill at preventing surprise pregnancies—more than 99 percent effective to be precise. During college, my daughter commented that she was glad to have her IUD because “if I do something stupid or am sexually assaulted, at least I won’t have to worry about pregnancy on top of everything else.” Also, because they are good for anywhere from 3 to 10 years, they offer women sustained protection when systems of care or social order break down—like now. In the US, Upstream USA has been working with care systems to upgrade services so that all women have access to the birth control method of their choice without financial costs or other barriers. After Delaware retooled family planning services across the state and many women switched to an IUD or implant, unsought pregnancy dropped by more than 40 percent.
So did abortion, the back-up when all else fails. Conservative politicians are using the pandemic as an excuse to eliminate abortion access by declaring abortion a nonessential medical service. That—together with economic uncertainty and the widespread prospect of serious illness—makes preventing mistimed and unwanted pregnancies even more urgent.
Valerie Tarico is a psychologist and writer in Seattle, Washington. She is the author of Trusting Doubt: A Former Evangelical Looks at Old Beliefs in a New Light and Deas and Other Imaginings. Her articles about religion, reproductive health, and the role of women in society have been featured at sites including The Huffington Post, Salon, The Independent, Quillette, Free Inquiry, The Humanist, AlterNet, Raw Story, Grist, Jezebel, and the Institute for Ethics and Emerging Technologies. Subscribe at ValerieTarico.com.