“Low-income women were using less of the most effective contraceptive methods–things like the pill–and they were more likely to be using methods like condoms only no birth control at all,” explained Elizabeth Nethery, lead author of the study and PhD student.
Women between 15 and 24 were polled for the study. Those with an annual household income less than $80,000 were found to opt for cheaper contraceptives or none at all.
Nethery says the research doesn’t determine that women are choosing their birth control methods strictly because of cost, but the clear trend indicates it’s likely a strong factor.
The study says birth control pills, which are about 94 per cent effective in a real-world use situation, can cost up to about $50 per month. Condoms are more affordable at about $1 each, but they’re less reliable–the study’s research team says about 15 out of every 100 people who use condoms as their only birth control method will get pregnant each year.
“We have been long trying to be able… to make sure that anyone who wants birth control can get it,” said Moncayo. “We really push hard for IUDs because with the chaotic lifestyle, substance abuse, poor mental health, and homelessness, it’s so much easier if they have an IUD.”
She says the issue comes down to funding–an intrauterine device (IUD) costs around $400 for a five-year implant. If patients don’t have any kind of government assistance or benefits plan, a birth control prescription like that becomes that much further out of reach.
Moncayo says the clinic does fundraisers to get IUDs to give to women who don’t have the means to pay for one. She says women she treats are much happier when they had a reliable form of birth control and that Canadians need to stop treating access to contraception as a luxury.
“It’s too bad people can’t think outside of the box to make sure [birth control] is funded appropriately.”
Would something like a national pharmacare program help eliminate barriers? Undoubtedly, says Moncayo.
“It would help so much–it would help with prenatal vitamins, it would help with contraceptives, it would help curb repeated unwanted pregnancies in the hardest to help [population].”
And Nethery agrees.
“What we’re calling for in this study… is we really need better coverage for contraceptive care in Canada,” said Nethery.
“We don’t have access to contraceptive care across the board equally. So, I think this is one more piece to add to the conversation to say we really do need to talk about how we can improve access equally to all Canadians.”
Netherly says the study didn’t look at regional differences between specific cities or urban and rural centres, but researchers did find a difference between the northern territories and the provinces.
“We saw similar trends in terms of lower use of more expensive methods in the north compared to the rest of Canada.”
Read more from the Elephant in the Womb reproductive rights series here.