Levi Johnston, infamous for his association with former Vice Presidential candidate Sarah Palin’s daughter Bristol, is once again in the media. He and girlfriend Sunny are expecting a child together and have informed the pressthat the pregnancy was unplanned. According to Levi, “There was a time we went to the cabin and forgot the birth control pills and, you know, about a month later we found out we were having a baby.” Many readers may merely laugh and move on, but we think it deserves more attention and consideration than that – this is a teachable moment.

In the United States, half of pregnancies are unplanned and many women have become pregnant as a result either of having forgotten to take their pill or of using their method incorrectly. This is a public example of an event that happens to many women even when safe and effective “get it and forget it” methods such as the intrauterine device (IUD), implant, and injection are available. Other monthly methods such as the ring and patch make it easier to maintain consistent use. And condoms work, too.

Instead of mocking Levi’s many adventures in contraceptive use (or lack thereof), let’s have a serious discussion about how to expand access and adherence to the various methods that are available to those who do not wish to become pregnant.

Information

A 2009 report by The National Campaign to Prevent Teen and Unplanned Pregnancy found that many young people have little information about common methods like condoms and pills and even less information about less common but more effective methods such as the implant and IUD. These same young people have many misperceptions about side effects and health risks associated with contraceptive use. 

This is not really surprising when conservatives advance laws pushing abstinence-only sex education and in some cases barring access to evidence-based, comprehensive information that provides young people with all of their options. If there’s one thing we should have learned by now, it’s that “just say no” just doesn’t work.     

Reproductive health professionals, providers, and educators must do their best to present those wishing to prevent pregnancy with the full range of contraceptive options available, share information on potential risks and benefits, and then let the user decide. 

Access

Many of us have seen the Birth Control Cost Calculator put out by Mother Jones. (If you haven’t, you should definitely check it out.)  Bottomline: Birth control isn’t cheap.  Preventing pregnancy, maintaining your health, and achieving your fertility goals can be a financial rollercoaster.  Some don’t even get on the ride because of just how costly it can be – even for people who have health coverage. 

The no co-pay contraceptive coverage provision in the Patient Protection and Affordable Care Act will help more women access the most appropriate and effective contraceptive method for their unique life circumstances. This conversation should include long-acting, reversible contraception (LARCs) – an important option for people who are not interested or ready to become a parent.

Options

There are many factors that go into the choices that women (and men) make about their contraceptive options including safety; efficacy; ease of use; potential side effects; reversibility; and protection against sexually transmitted infections. Lack of accurate information and financial barriers should not be added to that list. 

It does sound surprising, but in this case perhaps we can all learn from Levi Johnston.