WOMEN AND GIRLS’ reproductive health is not a marginal concern, it is fundamental to the health of society as a whole. Yet the historical lack of attention and investment has hampered women’s ability to realise this right in full.
For too long, contraception has been a woman’s private and personal responsibility. Open conversations about sexuality and sexual health were taboo and the absence of robust, rights-based sex education in schools prevented informed decisions around contraception. Paying for contraception was simply accepted as the price women had to pay for peace of mind.
This week’s announcement to roll out free contraception for women, starting with 17-25-year-olds, represents a real milestone. Combined with the announced action on period poverty, and with ongoing Government support, this could herald a new era where the distinct needs of women and people who menstruate are recognised and addressed.
Budget 2022
Universal contraception challenges the culture of silence and helps shift the dial from individual onus to collective responsibility. It is a clear recognition by the State that contraception is fundamental to reproductive rights and requires Government investment and support.
It is acceptance, after years of campaigning by the National Women’s Council, our members and many others, that women and people who menstruate should be able to make decisions on contraception based on what method best suits their bodies and their lives, not on what is cheapest.
A key element in this policy that the National Women’s Council wants to see is the inclusion of Long-Acting Reversible Contraception (LARCs). LARCs such as the copper coil or hormonal IUS are ‘fit and forget’ contraceptives which are widely recognised as the most effective method, reducing the risk of an unplanned pregnancy to less than one per cent. Yet uptake of LARCs is relatively low in Ireland due to upfront costs of €350-plus, as well as lack of information or awareness of them.
For younger women who have borne the brunt of the economic impact of Covid-19 through loss of employment in retail and hospitality, as well as those who are on student loans, this high upfront fee was a huge obstacle to access and one which impeded meaningful choice.
We know that in the absence of State support, many women were forced to use cheaper, less effective alternatives which increased the risk of crisis pregnancy. For these reasons, we support the decision to begin with the 17-25-year-old age range.
But we must be clear that this is only the beginning. Reproductive health justice can only be delivered by fully removing the cost barrier across the whole of the reproductive age range and enshrining the key principle of choice for all.
Contraception for all
The ability to choose if or when to have children is basic healthcare, not a radical proposal. And we need sustained investment and political commitment to ensure everyone can benefit. In particular, we are mindful of disabled women, Traveller and Roma women, and women affected by homelessness for whom cost continues to preclude.
Similarly, we know that universal contraception has huge benefits for everyone who needs it, including men, trans people and non-binary people. Universal contraception does not only limit unplanned pregnancies and reduces the need for abortions. It stops the spread of sexual transmitted infections (STIs) and supports overall reproductive health, including uptake of smears and management of menstrual health conditions. This is why we need to see further Government action to ensure access to contraception for all.
Developing a National Contraception Strategy will be critical for coordinating universal roll-out, beginning with 17-25s. A national strategy should map levels of readiness in different pockets of Ireland and enable targeting of appropriate investment into infrastructure and staffing where required.
We know that national coverage of abortion care, a critical issue for women and pregnant people, has not been achieved, with just one in ten GPs and half of maternity hospitals providing abortion care.
We must learn from this experience to ensure full access to contraception. This means universal contraception should be provided across all primary care, family planning clinics, pharmacies and hospitals.
Educate, educate, educate
Finally, while removing the cost barrier to contraception is a crucial first step, we must urgently address the pervasive stigma and shame which surrounds sexuality, menstruation, and contraception.
Alongside universal contraception, the Joint Oireachtas Committee on the Eighth Amendment highlighted the importance of sex education. The re-development of the SPHE and Relationships and Sexuality Education curriculum is the perfect platform to dismantle taboos and ensure that all young people receive accurate and accessible information on their reproductive rights and health.
With the announcement to roll out universal contraception in Ireland, starting with young women, the Irish Government has shown leadership. If we build on this, Ireland has the opportunity to be a world leader in properly resourced, comprehensive sexual and reproductive health services.
Orla O’Connor is Director of the National Women’s Council, the leading national representative organisation for women and women’s groups in Ireland.
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