If you browse through the required school curriculum in Texas, you might be surprised to find that sex ed doesn't quite make the cut. Sex education is optional in the Lone Star State and state law requires schools to stress abstinence when choosing to teach the subject, which can make understanding birth control even more confusing for both teens and adult women.
UTHealth School of Public Health launched its Own Every Piece campaign as a way to empower women with information on birth control and ensure access to contraceptive care regardless of age, race, relationship status or socioeconomic status. One click to the Own Every Piece website and you'll be greeted by the smiles of diverse women, along with videos of their birth control journey and educational information on various birth control options.
"You feel like the campaign is talking to you as a friend, not talking down to you as an authority or in any type of shaming way," says Kimberly A. Baker, assistant professor at UTHealth School of Public Health. One of her favorite areas of the website is the "Find a Clinic" page, connecting teens and adult women to nearby clinics, because "one of the biggest complaints from women is that they didn't know where to go," says Baker.
The website and social media platforms preach of body-positivity, empowerment, and knowledge. Prompts from a "true or false"-style quiz debunk myths from birth control weight gain to proper condom use on the home page. In the name of inclusivity, women can even upload their own birth control story to share with Own Every Piece's audience.
Baker and her team got their start in school districts developing programs for middle and high schoolers while also training teachers on how to discuss birth control openly. After working in over 20 school districts with the goal of preventing teen pregnancy through education, Baker identified a new problem: the significant lack of access to health care within the Houston community.
"We wanted to figure out what the major gaps were," Baker says. "What we found, of course, was how expensive birth control was — especially with some of the most effective methods."
Kimberly A. Baker is assistant professor at UTHealth School of Public Health. Photo courtesy of Own Every Piece
Let's crunch some numbers. When interpreting the price of contraceptives, the type of birth control and access to health care can impact how much women pay out-of-pocket. According to Baker, the standard pill can cost anywhere from $10 to $30 a month while implanting long-acting reversible contraceptives like the IUD can cost upwards of $600 to $700. These calculations don't factor in the cost of a doctor's appointment, the removal of a device like the IUD, or even the average $4,500 it costs to give birth if you choose to have a child in the U.S.
After noticing gaps in who could pay for service, Baker and her team realized that some community centers didn't have the funds to have long-acting contraceptive on hand.
"We knew if we partnered with health clinics and health centers to help train them to better serve folks that they weren't serving well, and to give them more funds to buy methods that women couldn't probably afford...we would be filling that gap," she says.
Creating comfort and trust among women looking for contraceptives was another key intention in the campaign's launch.
"When [women] enter a community health clinic, they should feel confident to ask questions and to know that they're receiving all the accurate information they should be getting so they can make the best decision for them," says Baker.
Baker likes to think of the Own Every Piece project as a "more celebratory campaign around birth control that we hadn't seen before," she says. "There are so many stereotypes around sexuality and reproduction that are very shame-based," says Baker, particularly for "Latinx and Black women."
She acknowledges how epithetical birth control messaging that suggests women shouldn't "have more kids" or implies "pregnancy is a bad thing" frames reproductive health in a negative way. "We wanted a campaign that let women know that they own their body. They make decisions about their body, and birth control is a piece of that," she says.
The purpose of providing access took on a new meaning when the coronavirus hit. Since Own Every Piece began as a digital campaign targeted to Houston women ages 18 to 30, the initiative had a head start in the race to move online.
"We saw an opportunity to figure out how we can tell our community health centers to get into the telecontraception space because we've already established trust virtually through our campaign," explains Baker.
Prior to the COVID-19 pandemic, Texas held the title of the state with the most uninsured residents in the U.S. In a state with 2.9 million unemployment claims since March, access to affordable birth control has never been more essential for women.
"From women who lost their insurance due to losing their job because of COVID-19, this has been a godsend," says Baker.
Telemedicine has also added convenience for women who didn't have the time to check out a clinic in-person before the pandemic.
While COVID-19's strains on American health care continue to dominate headlines, birth control has also managed to make national news. On July 8, the Supreme Court ruled that employers can opt-out of birth control coverage—a decision that could result in an estimated 126,000 women losing contraceptive coverage from their employers, according to the New York Times.
The 7-to-2 Supreme Court decision is the latest in a seven-year-long litigation over religious objections to birth control. Outside of pregnancy prevention, birth control helps women cope with premenstrual dysmorphic disorder, polycystic ovarian syndrome, endometriosis, acne, and a number of other issues.
"We have to work harder to have inclusive messaging around [birth control usage], because birth control isn't just about pregnancy prevention," explains Baker. "People use birth control for a number of needs. When you message it just around pregnancy prevention, people start to feel like something is wrong with being pregnant, and that's not what we set out to do."
Photo by Iwan Baan