Even if you currently have access to affordable, safe, convenient, and confidential reproductive health care, that may not always be the case. Changes in your health insurance status, state and federal laws governing reproductive health services, and even unprecedented pandemics can threaten your reproductive and sexual freedoms overnight. At Choix, we are actively working to safeguard your access to this critical care, which is essential to your sexual and reproductive well-being, through our innovative telehealth platform. 

What Is Reproductive Health?

Reproductive health is social, physical, and mental well-being in all matters concerning reproduction. It includes the ability to have and enjoy safe and satisfying sex, the capability to have children, and the freedom to choose when, if, and how to have children.  

Reproductive health is more than the birds and the bees – it can encompass all of the following essential parts of health:

  • Sexuality education
  • Family planning (contraception)
  • Sexually-Transmitted Infection (STI) screening and treatment
  • Menstrual care
  • Pregnancy
  • Infertility evaluation and treatment
  • Treatment for reproductive disorders such as pelvic pain or polycystic ovarian syndrome (PCOS)
  • Sexual dysfunction
  • Urinary problems such as leaking urine or urinary tract infections (UTIs)
  • Gynecological cancers such as cancer of the cervix, uterus, or ovaries

How Is Sexual Health Different From Reproductive Health?

People sometimes use the terms reproductive and sexual health interchangeably, even though they are not the same. Reproductive health involves the potential for pregnancy while the pre-requisite for good sexual health is “a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence.”

Sexual and reproductive health services can be abbreviated as SRH.

How Does Access to Sexual and Reproductive Health Care Benefit Health

At their core, sexual and reproductive health services are preventative medicine. Through family planning, teaching healthy behaviors, and the screening and treating reproductive diseases, SRH services are proactive, not reactive.

Speaking in financial terms for a minute, the long-term return on investment for dollars spent on increasing access to SRH services is significant in terms of medical, economic, and social benefits such as:

  • Greater financial stability and independence with access to contraception
  • Lower rates of sexually-transmitted infections (STIs), teen pregnancies, HIV, gynecological cancers, infertility caused by untreated STIs
  • The ability to treat painful periods, menstrual regulation and other non-contraceptive health benefits that come with access to hormonal contraception Improved maternal health (fewer women dying in childbirth or experiencing severe complications, preterm deliveries, miscarriages, or stillbirths)
  • With better access, if abortions are needed, they are completed earlier in pregnancy when they are safer and less complicated.

How COVID Proved Lack of Access Harms Health

While the overall effect of COVID-19 has been devastating, the pandemic did provide direct, quantifiable evidence of the importance of access to sexual and reproductive health.

As the world shut down at the beginning of the pandemic, so did doctors’ offices, health clinics, and abortion care providers. We were encouraged to “just stay home,” and many people skipped preventive care visits such as Pap smears and mammograms. We also waited out symptoms to see if they would go away on their own and delayed appointments for contraceptive counseling or STI screening.

Research shows that COVID’s toll on health affected those who identify as female more than males. Women and people with uteruses were more likely to go without necessary healthcare than men were during the pandemic. The same survey found that one out of every five people who have a period  in fair or poor health did not refill their prescriptions, skipped doses, or cut pills in half during the COVID-19 pandemic. More women than men also reported not being able to get an appointment or access urgent care, especially those with lower incomes, without health insurance, and in poorer health.

The numbers are still coming in, but they show that sexual and reproductive health suffer when access is taken away. One WHO survey reported that between June and September 2021, contraceptive use fell in almost half of the countries surveyed, while teen pregnancy rates rose in those same countries. Global public health experts cautioned that sexual and reproductive health care services need to be “at the center of COVID-19 pandemic response and recovery,” not restricted or limited as non-essential services.

The rise in medication abortions and the US Food and Drug Administration’s (FDA) permanent approval of providing abortion pills by mail from providers like Choix demonstrated the need for access to abortion care, regardless of pandemic status.

Experts warn that sexually-transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis rose during the pandemic, disproportionately impacting youth ages 15-24 years old, gay and bisexual men, and ethnic and minority groups.

Beyond STIs, it will take years to see the cumulative health costs and years of life lost because of missed or delayed diagnoses of preventable or treatable diseases and cancers. The US Centers for Disease Control reported that in April 2020, breast cancer screening rates declined by 87 percent, and cervical cancer screening rates declined by 84 percent compared to the prior five months. The people who had to cancel, miss, or delay their screenings? Women of color and those living in rural areas. In this way, the COVID-19 pandemic only magnified existing barriers to access and furthered health disparities in sexual and reproductive health.

Current Barriers to Accessing Sexual and Reproductive Health Services in the US (COVID-19 aside)

Legal Restrictions on Abortion Service Providers

While abortion is still legal in parts of the United States, it has become more restricted and difficult to access. Since the US Supreme Court reversed the federal law’s protection of a person’s right to have an abortion in June 2022, individual states can now decide whether or not abortion is legal. As a result, the laws protecting people’s right to abortions and those laws criminalizing abortion care are changing rapidly. And even prior to the Dobbs verdict, between 2011 and 2017, states passed over 400 laws regulating abortion. These TRAP laws place impossible restrictions upon free-standing abortion clinics, forcing many to close. Clinic closures compound the many obstacles people seeking abortion care face. Delaying abortions because of lack of access increases cost and the possibility of complications from later abortions or self-managed abortions.

Clinic closures also have a trickle-down effect on broader SRH services. Many of these reproductive healthcare centers provide comprehensive SRH services in addition to abortion care. Reproductive and sexual health care is more than abortion care, but US politicians do not always recognize the unintended consequences of restricting access to abortion.

People need access to sexual and reproductive health care services even when they aren’t planning a pregnancy or trying to end one. For example, birth control pills have many non-contraceptive health benefits and can be used to treat acne, premenstrual dysphoric disorder, and heavy periods.

Lack of Access to Affordable Care

Healthcare costs threaten sexual and reproductive health and people’s economic security. Because of existing financial burdens, people may be more likely to skip or delay reproductive health care appointments when they can’t pay for care. As a result, rates of adverse reproductive health outcomes are higher among low-income and minority people .

People who cannot afford health insurance are less likely to have prescription birth control and are more likely to use a less effective contraceptive method like condoms. Not only do these factors delay diagnosis and treatment for reproductive or sexual diseases, but they also lead to more unintended pregnancies, higher maternal mortality, poorer health, and increased health costs.

Additional Barriers to Accessing Sexual and Reproductive Healthcare Services in the US

Health care is complex, even when you speak the language, have health insurance, can afford medications, have transportation, and have a work schedule that allows you to go to the appointment. For so many people in the US there are countless other barriers standing in the way of good health, especially when it comes to sexual and reproductive healthcare. Cultural taboos and stigma make it difficult, if not impossible, for many to get the care they need. Additionally, structural factors built into our healthcare system make obtaining SRH care even more challenging for those from underserved and minority communities. While not an inclusive list, other obstacles keeping people from accessing essential health care include:

  • Language and cultural barriers
  • Lack of inclusivity (few minority providers, LGBTQ communities afraid to access services)
  • Fear or resistance to comprehensive sexuality education
  • Medical racism and a history of being traumatized by the healthcare system
  • Low health literacy (inability to find, understand, and use health information)

 

For many people these obstacles are layered – perhaps they don’t have citizenship status and so can’t get health insurance, or they don’t speak English, or don’t want their community to know that they are sexually active, but need contraception and STI protection.

How Choix Is Safeguarding Your Access to Reproductive Healthcare

Access to sexual and reproductive health care is one of the most effective ways to tackle health disparities. Determining if, when, and how many children you want can provide more economic stability and freedom.

Your overall sexual well-being and reproductive health depend upon your access to safe, affordable, and effective contraception, medications for treating sexually-transmitted infections, and abortion care should you need it.

Online health care and telemedicine providers like Choix are revolutionizing reproductive health care. While in-person exams and care are still an important part of your healthcare, virtual care is a great complement to in person care, allowing you to talk to a health care provider from the comfort of your home without stigma or the stress of finding a clinic. Choix offers affordable, discreet, and safe reproductive health care online, regardless of insurance or documentation status. Get the care you need today at Choix.