The Future of Birth Control

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Perhaps at no other point in history has the role of contraception in society been so thoroughly explored, analyzed and debated.

On its 50th anniversary, the birth control pill has been portrayed both as a driving force of female empowerment and a means for women to put their fertility on hold, only to later “wake up” and realize they’ve pressed the pause button for too long. As the U.S. government continues to creak through the machinations of implementing the health-care overhaul, whether or not birth control pills will be labeled preventive medicine is still up for debate — though insurers have long covered Viagra. And though conservative religious organizations are still wary of promoting contraceptive use, the Pope himself ceded a tiny bit of ground in November by suggesting that condoms were appropriate in some circumstances to prevent the spread of HIV — remarks that many see as a step toward the middle ground. (More on Are Doctors’ Exams a Barrier to Birth Control?)

Cultivating that middle ground — namely, reducing unwanted pregnancies that end in abortion — is central to public-health efforts to promote contraceptive use. And while researchers, public-health officials and religious and philanthropic organizations may not share the same vision of the way forward, advocates for contraception as a tool for public health have two clear goals: greater access and more choice.

The keys to access are simple, if elusive: lower cost, and more emphasis on de-medicalization, which means more options that women can use themselves and buy over the counter, rather than requiring monthly visits to the pharmacist or regular access to a physician. (More on Do We Need Vitamin-Supplemented Birth Control Pills?)

As for choice, inventing new methods — and improving on old ones — is critical to providing greater access and efficacy. Spurred in new directions in part by grants from organizations such as the Bill & Melinda Gates and the David & Lucile Packard foundations, several promising new techniques that last longer, have fewer side effects, and are easier to use are making their way from lab bench to bedside table. A look at how innovation is enhancing contraceptive choice, both now and in the more distant future.

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