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Essay

Supporting Reproductive Autonomy Post-Roe

"My organization in Tulsa is making pregnancy tests, emergency contraception, and condoms available, but these solutions need to be scaled and distributed more broadly." Laura Bellis, a 2022 Aspen Healthy Communities Fellow, discusses ways to support reproductive autonomy beyond abortion access.

  • May 30th 2022

By Laura Bellis, Executive Director, Take Control Initiative (TCI)

Abortion rights may be regressing, but several decades of advancement in reproductive health technology leave us in a different place today. Aside from having an array of birth control methods beyond the pill, we also have at-home access to emergency contraception and pregnancy tests. Given our increasingly restrictive context, it’s critical to ensure individuals can obtain and use these items in more proactive ways to support reproductive autonomy.

The first home pregnancy test became available in the US in 1977, four years after Roe v. Wade was decided. The stick version we know today wasn’t available until 1988. Emergency contraception hit the market in the late 90s; Plan B only became available over-the-counter without age restrictions 40 years after Roe. Both have been long used in largely reactive ways: unless someone is actively trying to conceive, pregnancy tests are usually used when someone misses a period or is experiencing other symptoms, and emergency contraception is often picked up or prescribed after unprotected sex has occurred. 

Laura Bellis is a community health access strategist and organizer who leads TCI, the longest-running local contraceptive access program in the nation. She'll soon join other fellows at Aspen Ideas: Health 2022 (June 22-25).

Emergency contraception should be purchased proactively as a medicine cabinet staple because it is most effective the sooner it is used. In some cases, proactive prescriptions for an IUD or Ella would be another solution, especially in places where health centers and providers may not be able to see a patient right away. 

If pregnancy tests are used by sexually active individuals on a more frequent basis, there are health benefits. Identifying pregnancy earlier allows for timely access to prenatal care, earlier initiation of prenatal supplements and more time to get comorbidities under control prior to delivery. It also yields more time and opportunity to access legal abortion in the increasingly restrictive landscape unfurling across much of the US.  

These added layers of protection don’t replace condoms and other contraceptives, nor the need for safe and legal abortion access. However, this approach is important in acknowledging the reality that not everyone can cross state lines to access care and thereby deserves every preventative measure available to them. Rural communities and impoverished areas with significant financial and transportation barriers would be most served by having these contraceptive methods in the face of increasingly oppressive and restrictive reproductive policies. 

Regionally, community-based organizations such as Planned Parenthood, Jane’s Due Process, and my own organization in Tulsa, Take Control Initiative, are making pregnancy tests, emergency contraception, and condoms available, but these solutions need to be scaled and distributed more broadly across community and clinic settings before it's too late. Abortion laws and policies might be moving backward, but we can still leverage every tool in our personal and collective arsenals to maintain bodily autonomy.

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The views and opinions of the author are their own and do not necessarily reflect those of the Aspen Institute.  

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