The question of cost of and access to birth control has been in the national spotlight for weeks now – but where does South Los Angeles stand in all that?
The debate over a new policy that will make contraceptives available free of charge as preventative has raged on ever since Georgetown law student Sandra Fluke testified before congressional Democrats in support of the policy – and the aftermath, which involved talk radio personality Rush Limbaugh calling her a "slut" and a "prostitute."
Pointing to statistics released by the L.A. County Department of Public Health in 2009, Planned Parenthood Los Angeles' director of public affairs, Serena Josel, said that the community "has an unmet need for reproductive healthcare."
In particular, she pointed to numbers that showed that South L.A. "faces some of the highest rates of chlamydia ... in the county," with between 501- 950 incidents of chlamydia per 100,000 people. She also noted that the rate of births for teenage girls between 15 and 19 years old – "most of which are unplanned" – is at a whopping 74.1 percent (per 1,000 live births) in South Los Angeles, compared to the county's overall rate of 40 percent.
The AP's Lauran Neergaard reports that nearly half of the nation's 6 million-plus pregnancies every year are unplanned, and that unplanned pregnancy rates are far higher among low-income women than those in the middle- or upper-class – a trend that's backed up by the county's numbers. Neergard says that's because condoms, a cheap form of birth control, can fail – and also because the pill is ineffective if a woman forgets to take it every day, or if she can't afford a refill.
Besides the sterilization route, the most effective birth control methods are the implantable rod (e.g. Implanon), an intrauterine device (IUD) or a shot/injection (e.g. Depo-Provera). All three of those methods have a success rate of less than one pregnancy for every 100 women that use them. With the pill, that success rate goes down to five pregnancies for every 100 women; failed male condoms result in between 11-16 pregnancies and the rhythm method's odds shoot up to 25 unintended pregnancies per 100 women that use it.
As U.S. News and World Report points out, though, birth control can get expensive – and the range of cost for a single method of birth control can vary widely. For example, the publication reports, IUDs can cost between $500 to $1,000 up front, although they last for up to 12 years, meaning an annual cost that's potentially less than $100. That's less than the shot, which is taken every three months and cost between $35 and $75 each, totaling up to $460 with doctor's visit fees.
Birth control pills cost between $160 and $600 annually. Condoms, which range in cost from 20 cents to $2.50 each, average out to an annual cost of $150 for couples who use them twice a week.
As far as the implantable rod, Planned Parenthood reports a cost between $450 and $540, dependent on income. Removal costs between $490 and $580, and removal with reinsertion costs between $500 and $590.
Josel said that about 80 percent of patients at Planned Parenthood do not pay for their contraception, but also pointed out women who are accessing birth control without coverage pay around $50 a month, while insured women pay around $20 monthly.
"Costs do vary based on birth control method and insurance coverage," she said, "but for some women these costs serve as very real barriers to care."
Onyenma Obiekea, a program coordinator for Black Women for Wellness, a nonprofit located in South L.A. that works to promote heathy lifestyles , said South L.A. "lacks comprehensive healthcare" that "focuses on access to quality, culturally-appropriate and affordable" care for all women.
"Not only do women face barriers to healthcare in the form of quality and expenses," she said in an email to OnCentral, "transportation and distance become additional factors that contribute to the reproductive health inequalities of South Los Angeles."
And while the numbers do make it clear that South Los Angeles has an access problem when it comes to reproductive healthcare and birth control, Planned Parenthood isn't alone in its providing of subsidized care.
Roy Silver is a medical doctor at Her Medical Clinic on South Figueroa Street, a clinic which uses Family PACT, a program under the state's Department of Public Health that provides clinical services for family planning reproductive health at not cost to low-income residents.* To be eligible, patients must reside in California, be at risk of getting pregnant or causing pregnancy, have a gross family income at or below 200 percent of the Federal Poverty Level ($22,340 for one person in 2012) and have no other source of healthcare coverage for family planning services.
"It really is an amazing program that gives access to a lot of these women who don't have access to insurance or anything else," said Silver. At Her Medical Clinic, Family PACT provides all methods of birth control – pills, IUDs, even sterilization – to eligible women at no cost. He guessed most of his patients at the Figueroa location would "probably not" be able to afford birth control without Family PACT.
"I would assume most people couldn't pay for it if they had to," he said. Her Medical Clinic sees between 10 and 20 patients a day, six days a week.
Even with that kind of financial aid, though, Silver said people still need to use the birth control properly.
"The program is great, but then again, people still have to use the medication they get, or they have to come in time to get their birth control," he said. "Whether they don't take it correctly, they forget to take it, they're just irresponsible in taking it – whatever it is. Overall, I think the program is great because [without it] I think there'd be a lot of more unintended pregnancies than there already are."
*Family PACT's official website was down as of press time. Sacramento State University's Student Health Services' website provided a synopsis of the program.
Photo by Jenny Lee Silver via Flickr Creative Commons.