In this op-ed, Bex Heimbrock argues that over-the-counter birth control isn't enough, and that free distribution of contraceptives will make them truly accessible.
The right to consume is, arguably, an intrinsic value in contemporary America. A stroll down the grocery aisle reveals different brands and types of almost everything, providing seemingly endless choice: Hellmann’s or Kraft? Ibuprofen or name-brand Advil? Freedom to choose (with your wallet, of course) is at the forefront of the American Dream.
This is the narrative reproductive health activists all too often rely on: in America, we should be free to purchase whatever we like for our bodies. This is the narrative that helped push for the first over-the-counter birth control pill.
At first glance, the argument makes sense. According to Forbes, women are the world’s most powerful consumers, with the ability to greatly influence the markets. Why shouldn’t we be able to have our needs met directly at the store shelves? Our money matters, too! The FDA’s decision to approve Opill, a progestin-only oral birth control pill, is thus hailed as a victory; part and parcel of the American Dream.
There is no denying that making birth control available over-the-counter is a win. The legal fight against the ability to access birth control in America started with the Comstock Act of 1873, which criminalized mailing birth control via the U.S. Postal Service because it was seen as an “obscenity.” In the early 20th century, government-enforced sterilizations were carried out against marginalized people – in some states forced sterilization is still legal in certain cases. In the late 20th and early 21st centuries, rapid advancements were made in the field of birth control, leading to the wide variety of contraceptive methods available today. Still, advances in birth control have been met with barrier after barrier to access — including the recent FDA ruling on over-the-counter pills.
While the ruling will improve access to birth control (in fact, I testified in front of the FDA about the importance of an over-the-counter pill), it is still reproducing exclusion based on factors like socioeconomic status. Across America, access to birth control continues to be tenuous. In 2022, a Kaiser poll found that one in five uninsured women had to stop using a contraceptive method because they couldn’t afford it. The cost of Opill has not yet been decided, and because the pill is a monthly purchase, those costs will add up and reinforce challenging barriers to birth control.
Already, the ruling is being touted as a victory by advocates. Finally, we are tempted to say, the government trusts those who need birth control to make their own decisions about what they can and cannot consume. What this newfound trust really means, however, is that the government finally trusts us enough to let us buy our own autonomy.
There is little talk of the root cause of these barriers, which even this liberating ruling cannot fully overcome. When activists cheer the victory and walk away, they ignore a precious opportunity to continue working towards a world where basic needs aren’t commodified, where we no longer have to deepen the pockets of pharmaceutical companies just to control our own future. It is appalling that we ever had to ask permission for this. What’s even more appalling is that this concession is being hailed as the ultimate victory, even as it still demands our economic exploitation.
In post-Roe America, collectives both in and out of the U.S. have quickly assembled to provide free abortifacient medications to those in need. These helpers do not charge for their services. They make no money doing this vital work to effectively reduce the barriers to birth control access. By reclaiming our own ability to give each other what we need, abortion collectives provide a valuable blueprint to those who wish to take their autonomy back – instead of buying it on the store shelf.
In fact, one of the only ways to make sure that birth control access is no longer tied to the problematic history of the state’s exercise of power over our reproductive rights is to distribute it freely amongst communities. If the Opill is safe enough to be on store shelves, it is safe enough to be liberated from those shelves and placed in our capable hands — regardless of socioeconomic status.
But wait, some might object, why can’t we celebrate this victory? Surely the rest of this justice will come later, why should we still be angry?
To this objection, we should recall the works of theorist Sara Ahmed, who embraces the term Feminist Killjoy. Ahmed writes in favor of the feminist who gets in the way, who sees advocates’ celebration of victory as an attempt to ignore the structural issues still at hand.
As people who are reckoning with the fact that our autonomy is earned through more spending and consuming – that our rights only exist if we can afford them – we should not be afraid to kill the joy of this moment in order to bring our complaints to the surface. For Feminist Killjoys, further inclusion into the American Dream of consumption is something that should be resisted.
It is crucial that we give ourselves permission to be angry and disruptive, even during supposed victories. This anger demands something better. It exists because you know there is more to feminist liberation than the American Dream.
I urge us to dare to constantly demand better, for ourselves and our communities. We should be tired of asking for incremental progress, while continuing to be exploited and simultaneously told that it’s our choice: Hellmann’s or Kraft?
This is the illusion of choice. We must move away from the market shelf and towards forms of community power, like abortion pill collectives, that refuse to allow birth control’s commodification and deny states control over our bodies. Only then will the pill truly be accessible.
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