Budget 2021 and contraception

Sir, – I write to you as an Irish-trained doctor working in Women’s Health in Australia. I write to celebrate the wonderfully progressive step our State has taken in the recent Budget by providing free contraception to women aged 17 to 25. This is to contrast the overwhelmingly negative reviews that appeared online and found their way across the globe. Our recent history in this space is significant to the contrary: the iconic “contraception train” movement occurred in only 1971, contraception was decriminalised in 1980 and finally approved for sale in 1985. Now, a generation later, we can provide it for free to young (and very likely unmarried!) women.

I wish to address a few points raised by opposing parties.

“Limiting” contraception to women aged 17-25. Women in this age group are more likely to be in part-time employment or unemployed, in full-time education and not have financial independence. The consequences of an unplanned pregnancy can be detrimental at any age, but there is clear evidence that within this group, an unplanned pregnancy significantly changes the trajectory of a woman’s education and employment status. Women are more likely to not complete their education, not obtain full-time employment and consequently forced down a path they would not otherwise have chosen; often relying on State financial support to provide for themselves and their family. It is therefore very logical and justified to prioritise this group.

“Giving the message that contraception is the sole responsibility of women.” It is women who end up being responsible for the unplanned and unwanted pregnancy. It is women who carry the burden of risk associated with a termination of pregnancy, with continuing a pregnancy and the side-effects of said contraception. It is therefore entirely appropriate for women to be prioritised. It is remarkable that women are being given the ability to advocate for themselves and to take ownership over their reproductive health. This should be encouraged, celebrated and continued.

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Is the budget perfect? No. Do we need more? Absolutely. Should both males and females be educated on contraception? Of course.

As a society, we should always strive for improvement, strive for progress and strive for change. However, given our history and the advances we have made in a relatively short time, we should pause, take a moment and celebrate this change and a progressive move towards equity in reproductive health.

Let us shine a positive light on the health services available to the young women of Ireland. – Yours, etc,

Dr S WALSH,

Melbourne,

Australia.

Sir, – This letter is prompted by the recent Budget announcement that free contraceptives are to be made available next year to women aged 17 to 25. It is reported that €10 million a year has been allocated for this purpose.

Earlier this year, when Peadar Tóibín TD asked the Minister for Health about the cost of our new abortion regime, he was given a figure of €20 million for the two years 2019 to 2020. That too averages out at €10 million per year.

That means that our Government now plans to spend €20 million a year on the prevention of births, whether by abortion or contraception. I am discounting any effect that free contraception might have on abortion numbers, because I have seen no evidence from other countries that free contraception leads to lower abortion numbers. Quite the opposite, if anything.

In the background here is an Irish birth rate that is declining alarmingly, and which is now far below the population replacement rate. It is very strange indeed that the Government is introducing incentives to reduce the birth rate further.

In contrast, there appear to be no State incentives to encourage births. A GP managing a pregnancy is paid far less than a GP prescribing abortion pills (€250 versus €450) even though the pregnancy requires far more GP visits. Pre-abortion counselling is not funded at all. Organisations such as Gianna Care and Every Life Counts, which assist women continuing with crisis pregnancies, are given no State funding whatsoever. – Yours, etc,

JIM STACK,

Lismore,

Co Waterford.