At long last: your birth control pills will finally be covered by insurance! The U.S. Department of Health and Human Services has announced sweeping new guidelines for women's health care to take effect Aug. 1, 2012. Among other things, these new guidelines will classify birth control pills as preventative medicine, meaning they'll be covered without co-pay or deductible. "Victory!" the email from Planned Parenthood cried. Huge news, hugely important -- and it has us thinking about something else. Something that might surprise you.
With the co-pays soon to be off the table, we got to wondering about the real cost of birth control.
It's tricky territory, touched upon in a recent issue of New York Magazine, which screamed from the cover: Fifty years ago, the pill ushered in a new era of sexual freedom. It might have created a fertility crisis as well. And again in the form of a personal essay by Elaine Gale, called Breaking up with feminism: A heartbreaking loss led to a new and deeper relationship-with the Feminine.
At issue: the not-so pleasant side effect of the power to impose a little control over our reproductive lives: that while we indeed have incredible control to suppress our fertility (while still expressing our sexuality) while we establish ourselves professionally, or financially, or just allow ourselves to get the sowing-of-the-wild-oats out of our systems, well, we don't have control over when our reproductive systems time out.
Just typing that out loud feels like we're traitors to the cause. Because, you know, the Pill is a good thing, as we've mentioned before. As Vanessa Grigoriadis writes in the NY Mag piece,
...the Pill, after all, is so much more than just a pill. It's magic, a trick of science that managed in one fell swoop to wipe away centuries of female oppression, overly exhausting baby-making, and just marrying the wrong guy way too early.
True, dat. Quoting Kelli Conlin, president of the National Institute for Reproductive Health, Grigoriadis goes on:
"Today, we operate on a simple premise -- that every little girl should be able to grow up to be anything she wants, and she can only do so if she has the ability to chart her own reproductive destiny."
...These days, women's 20s are as free and fabulous as they can be, a time of boundless freedom and experimentation, of easily trying on and discarding identities, careers, partners.
And, you know, why shouldn't we take equal part in that experimentation -- a time that's become so fundamental to the American experience, science types are trying to get it distinguished as an entirely new life stage? The Pill gave women power and freedom and equality -- and what could possibly be more empowering than that? These very things were the great promises of feminism.
Which brings us to Gale's story:
I loved all the things Feminism whispered to me at night when I couldn't sleep:
"You deserve the world on your own terms."
"I will take care of you and make sure that things are fair."
"You can have it all!"
...Meanwhile, my life had a repeating narrative: professional success, romantic mess. There was Mr. Right Now, Mr. Adorable Slacker, Mr. Too Bland, Mr. Has Potential, Mr. Too Old For Me, and then Mr. Artistic But Unstable.
I always thought that I had plenty of time to get married and crank out some children. Women can do anything they want when they want, right? That's what feminism was always whispering in my ear.
Then, at age 36, she married her husband. She writes:
We decided that we wanted to have a child, although at the time, I partly saw it as another box to check off. After the miscarriage, feminism and I had our falling out.
What's feminism got to do with it? Here's Gale's take:
Feminism was always going on and on about the importance of having choices. But I found that my biological choice to have a child was snatched away from me while I was being liberated.
I had been told that I could have my career first and have children second. That it wasn't either/or. I thought that it was going to be better for us than it was for our mothers. But my mom ended up with a wonderful career as a university professor and had three children.
Confused, I rued the day I fell under feminism's sway. How could I have been so naive? How could I have put off having children so late that I have possibly missed the opportunity to have children at all?
Tough stuff. And props to Gale for that kind of blunt honesty. And, in terms of delaying pregnancy, she is hardly alone.
The CDC, which surveyed data between 2007 and 2009, found that the birth rate for women over 40 in the United States rose steadily in those two years. In other age groups, it fell by 4 percent. Researchers claim that it is the sharpest decline in three decades.
...women aged between 40 and 44 experienced a 6 percent increase in births. Meanwhile, women aged 20-24 ("peak childbearing years") apparently decided to put babies on hold, as birth rate in that age range plummeted 9 percent.
One analysis attributes this phenomenon to fertility medicine. Makes sense. The study itself draws a link to the economy. That makes sense, too. And, when looking at such steep changes over such a short period of time, those things are likely no small part of the story.
But. We think there are other factors at play here, too, part of a larger trend. The same kind of things that we believe to be behind the Extended Adolescence phenomenon, the same kind of things that we believe to be behind the kind of commitmentphobia New York Magazine and Lori Gottlieb have written about.
Namely, that having a whole lot of options (or being told you have a whole lot of options) breeds a certain reluctance to commit. And what could possibly be more of a commitment than a baby? Real estate? Marriage? A job? A move? Bangs? Please. With the possible exception of a tattoo (although I hear they're doing impressive things with tattoo removal technology these days), a baby represents the ultimate in commitment. Women today have been sent out to conquer the world. We've been told we can do anything, that we can have it all! And that we are so very, very luckyto be able to do anything, to have it all! And, given those messages, is it any wonder we're a little gun-shy when it comes to commitment? Is it any wonder we want to get our fill of the world and it's opportunities before we sign on to settle down?
But it's more than that. A baby represents a far greater lifestyle change for a woman than for a man: even if the woman and the man are parents to the same child. In all likelihood, it'll be mom who'll take a time-out from the working world (and she'll probably-and by "probably" I essentially mean "most definitely"-get dinged for it) -- but most families today can't afford to have one-half of the breadwinners at home forever. Especially with a bonus mouth to feed, a mouth which may one day need braces, a mouth in a head that will one day require a college education... So it makes a lot of sense that a woman might want to wait until she gets a little more established, professionally, before she takes herself out of the game, even if its only temporarily. Because once she jumps back in, she'll find she'll be paying a price.
Back to Grigoriadis:
The fact is that the Pill, while giving women control of their bodies for the first time in history, allowed them to forget about the biological realities of being female until it was, in some cases, too late... Inadvertently, indirectly, infertility has become the Pill's primary side effect.
And ironically, this most basic of women's issues is one that traditional feminism has a very hard time processing the notion that this freedom might have a cost is thought to be so dangerous it shouldn't be mentioned.
And that, we tend to think, is the real trouble here. Not the cost itself -- but the reluctance to admit to it. It seems to me that we're shying away from what may be the biggest challenge for women today: admitting that freedom might -- no, does -- come with a cost. In the reproductive realm, yes, clearly -- but in the larger sense too: We're missing the rather nasty message that every choice entails a trade-off. That we can't have it all.
You read that right, sister. You can't. I can't. No one can. It's an ugly message, so is it any surprise so few of us want to go there?
So often, when we talk about "choice," we focus on all the options, and the things that we choose. But, by its very definition, making a choice entails not choosing something else. (It's no coincidence that the word "decide", the very word we use for making up our minds, ends in -cide -- which means to kill.) We just like to leave that part out; we don't talk about it.
But we think we should talk about that. Not least because there's something about talking about stuff that makes even the suckiest of stuff suck a little bit less. Seems like Grigoriadis might agree:
Sexual freedom is a fantastic thing, worth paying a lot for. But it's not anti-feminist to want to be clearer about exactly what is being paid. Anger, regret, repeated miscarriages, the financial strain of assisted reproductive technologies, and the inevitable damage to careers and relationships in one's 30s and 40s that all this involve deserve to be weighed and discussed. The next stage in feminism, in fact, may be to come to terms, without guilt trips or defensiveness, with issues like this.
The reluctance to discuss the very real consequences of putting off getting pregnant because we're afraid doing so would somehow discount the very important freedom that comes with being able to put off getting pregnant does us a disservice. Is that freedom of any less value because it comes with trade-offs? When we talk of choices only in terms of what we choose-and never with a nod to our feelings over what we consequently choose to leave behind... well, how empowering is that, really? (And when we talk of "having it all" as though all "all" entails is a big bowl of cherries, how are we to feel when we realize that, in aiming to have it all, what we've really wound up with is all of the work?)
They're tough questions, and they require tough honesty. Isn't there some kind of pill for that?