Women's health has been a focus of the Trump administration since its inception—and not always in ways that a majority of Americans would like to see it changed. First came the "global gag rule" that prevented governmental health programs overseas from providing contraceptive information and care to women in other countries. Then came the series of failed repeal-and-replace healthcare bills, which would have reduced funding for Planned Parenthood and Medicaid and removed mandates requiring insurers to provide maternity care—and would have cut access to healthcare for millions of women. After that came cuts to dozens of teen sex education and pregnancy prevention programs, many of which had been successful in reducing the teen pregnancy rates. And then, of course, came Trump's edict that companies could stop providing contraception coverage to their employees for "moral reasons."
And now, a leaked memo shows that they're planning to take things further, by moving sex education in schools toward abstinence-only programs—which has had limited success in stemming teen pregnancy rates—and trying to shift contraception in general toward fertility awareness, a technique which fails 24 percent of women each year, rather than the wide array of contraception options currently available to women.
That has many experts concerned, including Leslie Heyer, founder of Cycle Technologies, a global leader in the development of fertility awareness-based, family planning options. "I am deeply concerned that the administration is talking about promoting fertility awareness methods only," she told Parents.com. "While I’ve worked in advancing fertility awareness methods for many years, it would be an enormous disservice to women not to offer them a full range of contraceptive options. Research has shown repeatedly that having access to a full range of contraceptive options – which includes hormonal, barrier, and fertility awareness methods—is the best way to ensure that women find a contraceptive option that they will use correctly and consistently over time."
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Many times, fertility awareness and the old-fashioned term "rhythm method" are used interchangably, but Heyer says that's a disservice to the newer, more accurate fertility awareness methods. "The rhythm method is based on a mathematical formula that has been shown to not be particularly effective," she says. "Meanwhile fertility awareness methods have evolved in the last few decades with a lot of research and development. Some of them require extensive tracking of different symptoms such as period tracking, secretions, basal body temperature, and/or cervix position, while others take a more simplified approach and focus on just one or two of these indicators. Studies show that in both perfect and typical use, established fertility awareness methods are generally on par with other user-directed contraceptive methods such as condoms or even the pill."
So while fertility awareness can work, it may not work for every woman, at every point—it does nothing to prevent sexually transmitted diseases, for instance. And Heyer is concerned that it will increase the rates of unplanned pregnancy, particularly among teens. "I’m really worried that by reducing access to contraception and focusing on abstinence-only education, that we’re going to see an increase in unplanned pregnancies which will increase the number of abortions, and will hurt individuals, families and communities," she says. "Unplanned pregnancies have been shown to result in poorer health outcomes for both the mother and child, to put people in poverty and/or keep them in poverty, to reduce education and career opportunities both for the women who have them and for their families."
These changes are despite the fact that the vast majority of Americans support access to contraception and sex education. Heyer suggests donating to local organizations that provide contraception and sexual education, and making your voice heard, if you oppose these changes. "We need to let our current politicians know that access to contraception and reproductive healthcare in general is a critical issue that we want them to fight to protect," she says. "Longer term, we need to get more women into positions of power where they are shaping these decisions directly."