The battle for contraception and accessible healthcare

Source: Unsplash. 

*All names used in this piece are not real to maintain anonymity of sources.  

While contraception is typically used as birth control, a portion of those using different forms do so to alleviate symptoms including painful or heavy periods, symptoms of conditions like endometriosis and more.   

While Aotearoa New Zealand Government agency Pharmac funds a range of contraceptives, those aren’t always a viable option.  

So, what happens when you cannot front the cost of unfunded, or partially funded contraceptives, as well as administrative costs attached even to the funded ones, like doctors’ appointments and follow ups?

Holly* was diagnosed with endometriosis when she was 16 and was put on a funded pill to help with pain. When that pill didn’t help, she switched to another that was unfunded.  

Three months’ worth of the medication cost $52.  

“It is a huge chunk of my budget that goes towards my pill. On weeks I have to buy it I am unable to buy anything else but the bare necessities.”  

Had the contraception been funded, she would no longer have to juggle paying for medication on top of expenses.  

“Denying access for some people would be detrimental, or they might not be on the best pill for them. Birth control is super important for female health in both a sexual capacity and [for] so many other reasons such as endometriosis, other illnesses and acne, and making some funded and some not is a big divide.”  

Lucy* went on funded contraception at 13 because of painful, heavy periods.  

“My periods were so bad that I often found myself having to go home from school halfway through the school day … [the] doctor told me that it was normal and told me that going on birth control would fix it. I was a little disappointed to be told that my debilitating pain and bleeding through a heavy flow tampon every two hours was normal.”  

Lucy found it caused vomiting, acne, brain fog and fatigue and didn’t help with periods.  

Lucy’s contraception was always funded, so that bit was free. Otherwise, they have fronted prescription fees and doctors’ visits, which cost $60 when they turned 18.  

“There were some weeks I was unable to pay for pet food, petrol [amongst other things] as I had to pay for doctor visits instead. 

“Maybe if there was no funding towards any contraceptive methods then doctors would actually take into consideration what each patient personally needs. In saying that though, the same outcome could be achieved by ensuring there was funding towards every form of contraception.”  

Pharmac Senior Therapeutic Group Manager/Team Lead Alexandra Compton said the agency works to fund as many medicines as possible, but within a fixed budget.  

“We need to make our decisions by drawing on the best available clinical evidence as well as advice from clinicians and the lived experience of people with various health conditions.”  

Compton said the agency has also received a new funding application for combined oral contraceptives and are planning to seek clinical advice on this.  

Sexual Wellbeing Aotearoa Chief Executive Jackie Edmond said the organisation is a low-cost provider, working to keep services as affordable as possible.  

When asked why some contraceptive services are funded, while others are not, Edmond said it was complicated, and largely due to government level decisions.   

“We know there are many demands on the health budget, but we think sexual and reproductive health is so important that we want to see free visits whatever provider people choose to go to for all their sexual and reproductive health needs.”  

Edmond said Sexual Wellbeing Aotearoa would like to see sexual and reproductive health services available at no or low cost, with more options for contraception and to expand services over the phone.