Monday 16 September 2019

Orla O'Connor: 'Why a free contraception scheme is a must for women's health and well-being'

Protest: Women at Dublin’s Connolly Station heading to Belfast in 1971 to buy contraceptives, which were illegal here until 1980. PHOTO: The Irish Times
Protest: Women at Dublin’s Connolly Station heading to Belfast in 1971 to buy contraceptives, which were illegal here until 1980. PHOTO: The Irish Times

Orla O'Connor

Free contraception is the way forward for women's reproductive health, enabling women to choose the most effective contraception for their bodies and lives, without cost implications. It is so important women have control over their own fertility and reproductive health, and free contraception should be a part of any good healthcare system.

The Government committed to providing a scheme of universal access to contraception as part of an overall package to address women's health needs in a comprehensive manner. These commitments were made at the time of the referendum to repeal the Eighth Amendment and provide abortion in Ireland. It is important for women that this commitment is met in Budget 2020, and a scheme providing universal access to contraception is rolled out so all women can make informed choices around their fertility.

Continuing high rates of unplanned pregnancy, rising rates of sexual transmitted infections (STIs) and strong evidence of inconsistent contraception use show we are failing a large proportion of women when it comes to their reproductive health.

Access to safe, effective contraception for all women should be a cornerstone of women's healthcare. This is not a radical proposal, yet Ireland continues to lag behind our European neighbours in health service provision of contraception. This is in part due to our history, reflecting the lack of availability of any form of contraception in the very recent past - prescribing and having contraception of any description was illegal until 1980 and emergency contraception was not available without prescription until 2011.

Currently, significant cost and access barriers exist, such as lack of capacity at primary care and a lack of local services, which prohibit women from using their preferred contraception method. This has resulted in inconsistent use of contraception across the Irish population, low uptake of the most effective long-acting reversible contraception (LARCs) and increasing rates of STIs.

Women should be able to make decisions on contraception based on what method best suits their bodies and their lives, not on what is cheapest. The 2010 Irish Contraception and Crisis Pregnancy Study found that 24pc of adults in Ireland reported cost as a barrier to accessing contraception. Research demonstrates that those with fewer resources often use contraception inconsistently or don't use the most effective method of contraception because they cannot afford it. LARCs are widely recognised as the most effective contraceptive method, yet uptake is relatively low in Ireland due to upfront costs of €350-plus.

It is clear that women in the very midst of their reproductive years are finding it difficult to pay the cost of contraception. In many cases, women who have very significant overheads and squeezed income may consider contraception - and particularly the upfront cost for more expensive methods - beyond their means. This includes young women in their late teens or early 20s who may be students or working in low-income jobs facing high rents, or women in their late 20s and early 30s with young children who are also grappling with the high cost of childcare and housing.

This is why the provision of free contraception is so important. Contraception plays a pivotal role in the health and well-being of women, and we need a scheme which meets women's needs, with the full range of contraceptive methods made available, free of charge.

It is vital contraception provision accommodates the needs of all women, particularly those who experience the worst health outcomes and/or least access to health services, including migrant women, women with disabilities, Traveller and Roma women, homeless women, members of the LGBT community, young women and women in prostitution.

A core part of the provision of free contraception must be to ensure women are entitled to free contraceptive care consultations with a doctor. With this, Ireland has the opportunity to be a world leader in properly resourced, comprehensive sexual and reproductive health services. This would have the benefits of limiting unplanned pregnancies, reducing the need for abortion, stopping the spread of STIs and supporting overall reproductive health, including uptake of smears and management of menstrual health conditions. The scheme should be provided across primary care, family planning clinics, pharmacies and hospitals.

The development of safe, effective contraception is widely considered to be one of the greatest public health achievements of the 20th century. The National Women's Council of Ireland has submitted proposals for this scheme to the Department of Health, and we are calling on the Government to commit to free contraception in Budget 2020. Women cannot afford to wait any longer for quality healthcare.


Orla O'Connor is director of the National Women's Council of Ireland, Ireland's largest women's membership organisation

Irish Independent

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