The standard for women’s healthcare in the United States is supremely low. The U.S. consistently ranks among the lowest of developed countries for a number of factors, including maternal mortality and overall women’s healthcare. The so-called “Right to IVF Act,” under consideration on the Senate floor this week, would not meaningfully improve the quality of women’s healthcare, but an alternative bill on offer from Sens. Cindy Hyde-Smith (R-MS) and James Lankford (R-OK) could go a long way.
The problem with women’s healthcare in America lies at least in part with the medical establishment’s overprescription of hormonal birth control for girls as young as 12 with maladies as mundane as acne and as severe as heavy menstrual bleeding and cramps.
Little research has been conducted on the long-term health effects of hormonal contraceptives for young girls, and that which has been conducted does not bode well. And yet, more than one in three teenage girls and 65% of women under 50 report using contraception. Consider this in conjunction with the statistic that one in six women experience infertility, and it is clear that there is a breakdown in women’s healthcare across the board, from research to treatment, from menarche to menopause.
Hyde-Smith and Lankford are seeking to change those statistics with the RESTORE Act, an alternative to the in vitro fertilization bill on the floor this week. IVF, they argue, is not under threat at the federal or state level and, as such, needs no federal protection. Restorative women’s healthcare, however, receives little to no funding, research, or support, and it could reduce the number of women who seek IVF and the years of infertility experienced by those who use it. The methods promoted in their RESTORE Act not only increase the chances of women conceiving naturally and carrying to term, but are also drastically cheaper and less invasive than IVF, giving more families more options for reproductive health.
Among the most interesting provisions of the bill are Title X funding for restorative reproductive medicine and the expansion of research and literature reviews on reproductive health conditions and fertility awareness-based methods. Notably, the bill does not preclude further protections for IVF but proffers a pathway for reducing infertility and, thus, the need for IVF in the future.
This bill also comes at a time when a growing number of women are choosing not to take hormonal birth control for various reasons, from concern over the long-term effects of the drugs, to dislike for how they make them feel, to a desire to return to simpler or natural treatment options. Responding to this growing desire are a number of new companies investing in cycle-tracking and natural methods of fertility control, such as Natural Cycles (which was the first ever phone application to apply for and receive FDA approval as a contraceptive method), FEMM, Ava, Mira, and numerous others.
All this follows the Catholic Church’s pioneering of various natural fertility methods due to its wholesale rejection of contraception of any type. The Creighton method, the Marquette method, and the basal body temperature method were all developed by Catholics or Catholic institutions and form the basis for all fertility awareness-based methods now employed by the various apps and companies mentioned above. In 2019, certain fertility awareness-based methods were rated by the Centers for Disease Control and Prevention as being up to 98% effective for preventing pregnancy, which is more effective than the average birth control pill (93%).
Broadly speaking, fertility awareness methods focus on the female body’s natural hormonal rhythms, tracking specific biomarkers to identify which phase of the cycle a woman is in (including the ovulatory phase, which occurs for only 12-24 hours per month). With this uniquely personal data, these methods can predict with near-perfect accuracy a woman’s fertile window, as well as inconsistencies in her cycle, which can help diagnose underlying conditions such as endometriosis, polycystic ovarian syndrome, auto-immune disorders, and even certain types of cancer. As author and reproductive health practitioner Lisa Hendrickson-Jack has found, the reproductive system is a woman’s fifth vital sign; it should not be masked or inhibited, but supported and tracked very closely to ensure her overall health.
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The current standard of reproductive care for women in the United States is a prescription for the pill at 13 and a referral for IVF at 30, which is no standard at all. Women’s health research and treatment should attend to rather than mask or inhibit the female cycle, and women’s health education should include detailed information about the phases of the female cycle and the biomarkers that help pinpoint ovulation and/or underlying conditions. These types of methods are currently unsupported by federal programs, such as Title X funding, and are unrecognized by insurance agencies, making this fundamental knowledge privileged information for only the women who have the education and money to find it.
The RESTORE Act seeks to change that, and any senator who believes women deserve better should vote to pass it.
Katelyn Walls Shelton is a bioethics fellow at the Paul Ramsey Institute and the former special assistant for global women’s health at the U.S. Department of Health and Human Services. She studied ethics at Yale University and lives in Washington, D.C., with her husband, John, and their children.