Rupinder Toor is medical director and founder of Calgary’s IUD & NE Women’s Clinic and founder of the advocacy group Project EmpowHer. Amanda Black is president of the Society of Obstetricians and Gynecologist of Canada.
The concept of universal coverage of contraception – free birth control for whomever needs it – is gaining momentum. In April, British Columbia became the first Canadian jurisdiction to make prescription contraception free to all residents (and demand has since soared). This policy has been implemented in many European countries, the United Kingdom and New Zealand, and is gaining acceptance worldwide for good reasons.
There are clear economic benefits, with studies showing that for each $1 invested in universal contraception, up to $9 can be saved in the public sector. The economic benefits are realized quickly, with the policy being revenue-neutral by year two and saving money by year three.
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Contraception coverage varies widely across the country, and in a publicly funded health care system, it will always be cheaper to pay for contraception than to pay for unintended pregnancies. The most popular contraceptives are not the most effective, but they are the cheapest. Currently in Canada, 40 per cent of pregnancies are unintended, and while not all are undesired, about one in five pregnancies ends in an abortion. Direct health care costs alone for unintended pregnancies are estimated to be more than $320-million annually. This does not factor in larger downstream costs to the individual or to public systems like child care and education. “Free” comes with a public cost, but we should also consider the price we will pay for not doing something.
B.C.’s universal contraception coverage inspires call for funded birth control across Canada
In addition to the economic argument, we should also consider the powerful social value of universal contraception. It empowers individuals with a reproductive life plan. It strengthens individuals, families, and societies and it can break the cycle of poverty. When an individual can successfully choose when they become pregnant, this allows them more agency in their lives to pursue educational, career, and other life goals. Universal contraception reduces abortions and improves maternal, child, and societal health overall.
We are currently gathering signatures for a petition that will be presented to the House of Commons asking for the federal government to mandate universal access to free prescription contraception. But health care is typically a provincial jurisdiction – so why advocate for a federal policy?
Reproductive rights are human rights and must be protected at a federal level. They should not be up for negotiation with the changing ideologies of provincial governments. The United Nations and the World Health Organization have stated that access to safe, voluntary family planning is a human right, and that family planning is essential to promoting gender equality, advancing the autonomy of women, and reducing poverty. Having a universal single-payer approach expands choice and access while also preventing coercion while providing contraception.
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Hats off to B.C.: Universal access to contraception is good social policy
Canada is the only country in the world that has universal health care but lacks coverage for prescription drugs. The federal government has committed to a national pharmacare program and while the unrolling of this program will take some time, universal coverage of contraception could be an important, immediate and symbolic first step.
Reproductive rights are currently being restricted in the United States and elsewhere in the world. In this context, it is important to consider which policies define us as Canadians. The federal government, which has been an advocate for reproductive rights and gender equity, is now being called to action. And quite frankly, we are overdue for it. The birth control pill was legalized in 1969, but 54 years later, many still don’t have the access to contraception they need. If it is successful, universal contraception coverage will leave a legacy as one of the most progressive policies for reproductive rights and gender equity in Canadian history.
An overwhelming majority of Canadians agree. A recent poll shows 83 per cent of Canadians approve of free prescription birth control across Canada, and seven out of 10 feel the issue is urgent. Among voters of the three main federal parties in different regions across Canada, the support was 75 per cent or higher.
For all the right reasons, universal access to no-cost prescription contraception is an essential policy. It’s a crucial step toward ensuring reproductive autonomy and promoting gender equality in Canada. By removing financial barriers and increasing access to a wider range of contraceptive options, we can empower individuals, reduce unintended pregnancies, and create a more equitable society. Universal contraception coverage is not only a matter of reproductive health – it is an investment in Canada’s future.
