In the wake of the Roe v. Wade decision, a lot of people were left wondering: What does this mean for access to birth control and emergency contraception?
On Wednesday’s episode of This Is Nashville, we invited a panel of medical and legal experts to help break it down for us. Check out the highlights below to hear questions answered by Ashley Coffield, the CEO of Planned Parenthood of Tennessee and North Mississippi; Dr. Kimberly Looney, an OBGYN; and Ellen Clayton, a Vanderbilt law professor. For more information, listen to the full episode here.
What does the present situation look like for individuals seeking birth control in Tennessee?
Currently, all forms of birth control are available in Tennessee. This includes emergency contraception, hormonal birth control (like the pill, patch or ring), non-hormonal birth control (like condoms or the copper IUD), long-acting options (like IUDs or implants) and permanent birth control (like vasectomies or tubal ligation).
What is the difference between hormonal and non-hormonal birth control?
To put it simply, hormonal birth control has hormones in it, and non-hormonal birth control does not.
Hormonal birth control can either be a combination of hormonal drugs — estrogen and progesterone, which are two naturally occurring hormones in females — or utilize progesterone only. The latter option, Dr. Looney says, provides a wider safety margin for a lot of people, particularly if they have a complicated medical history.
Non-hormonal birth control are forms of contraception that are effective without the use of hormones. These options include condoms, copper IUDs and natural family planning methods (like timing your periods or withdrawal).
What forms of contraception does Planned Parenthood offer? Do they offer vasectomies?
Planned Parenthood offers all forms of FDA-approved contraception. For uninsured patients, Planned Parenthood will offer long-acting forms of contraception like IUDs, implants and the birth control shot, free of charge.
For teenagers who are either uninsured or electing not to use their insurance for confidentiality reasons, Planned Parenthood will offer all family planning services — including visits, STI testing and treatment and any form of birth control — completely free of charge.
Currently, Planned Parenthood does not offer vasectomies, but they plan on adding that service in the future. Ashley Coffield, the CEO of Planned Parenthood of Tennessee and North Mississippi, says Planned Parenthood has received a lot of interest in vasectomies, as it is not something that is easily accessible for uninsured Tennesseeans.
Can teenagers access birth control without parental permission?
Yes. In Tennessee, teens can consent to birth control without parental involvement. And, as Coffield reiterates, that would be free of charge at Planned Parenthood.
Will insurance cover birth control?
Under the Affordable Care Act, insurers are required to provide first dollar coverage for all birth control options, including those who are on TennCare.
“Unfortunately, we have a lot of patients who come in with insurance and find that they don’t have that coverage,” Coffield says.
In cases like these, where insurance companies find loopholes to get around the law, Coffield suggests people reach out directly to their insurance company and “ask a lot of questions.”
“And the other thing that I would say is they also need to see who their employer is,” Vanderbilt law professor Ellen Clayton adds.
Clayton says that since the Supreme Court has said that religious objections by the employer — no matter how distant or how broad — are grounds for refusing to provide contraceptives if it violates their religious beliefs, it may be impacting workers’ access.
Have more people sought out birth control since Roe v. Wade was overturned?
“Absolutely. We have been inundated with questions and concern and people coming in to make sure that they have the best option for them right now. There’s a lot of fear out there that wasn’t there before. We’ve also had a lot of men coming into our health centers and purchasing emergency contraception,” Coffield says.
Are there doctors in Nashville who perform tubal ligation (otherwise known as “tying tubes”)? Can there be pushback for individuals who do not already have children?
Yes. Many physicians in Tennessee perform tubal ligation.
However, pushback on the procedure can definitely be a barrier, Dr. Looney says.
“I think that it comes from a good place, although it can present an obstacle to health care for the patient … I think from the doctor’s perspective, you’re concerned about doing something permanent that will forever change her life, because you don’t know what circumstance is bringing her to that decision right now,” she adds.
Can the birth control pill have long-term impacts on fertility?
Birth control does not have long-term impacts on fertility, although sexually transmitted diseases do.
However, in the short-term, birth control can affect fertility.
“It can impact fertility, but not in the way that people think,” Dr. Looney says.
After stopping use of contraception, there can be something called a “rebound surge response.” In this instance, it is actually easier for some people to get pregnant.
Will the overturning of Roe v. Wade affect the sexual education curriculum in Tennessee?
“Our sexual ed curriculum here in Tennessee already has limitations that have been put on it by the legislature. So it’s already not in a good place,” Coffield says. Even before Roe was overturned, Tennessee had laws in place that prevented abortion providers from teaching sexual education in schools. This included Planned Parenthood.
“I think one of the issues with our school system in general is, and this is probably more of a U.S. problem than some other countries, is that we don’t acknowledge that sexuality is a normal part of growth,” Dr. Looney says.
Are there any long-term benefits to contraception beyond preventing pregnancy?
Yes. Birth control pills can decrease the risk of ovarian and uterine cancers, as well as help with things like dysmenorrhea (painful periods), menorrhagia (heavy periods), acne and mood.
What resources are there for anyone looking for more information on birth control?
Coffield urges anyone who is interested in learning more about birth control options to visit the Planned Parenthood website.
“It’s chock-full of information about all different forms of birth control, the range of options that Dr. Looney mentioned and what the pros and cons of each of those are for not just prevention of pregnancy but for other health conditions as well,” she says.
Is the right to birth control in peril?
Clayton says she thinks that the likelihood of contraception being banned statewide is very slim. She says that Tennessee has been proactive in promoting contraception, including to minors, as required by the U.S. Constitution.
However, following the Dobbs decision, she does cite Justice Clarence Thomas’s opinion as “concerning.”
“Frankly, any of the decisions that have to do with individual liberty, like contraception, like gay marriage, like gay sex and actually a variety of others I think, are now subject to being overturned,” Clayton says.
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