Recently, the Trump administration issued a ruling allowing employers to decline to provide birth control to their employees if it violates their “religious beliefs” or “moral convictions,” a direct override of a provision under Obamacare that required employers to provide free birth control. Although Obamacare permitted religious institutions to abstain from providing birth control to their employees, this decree expands that allowance to any institution or organization that believes it contradicts their beliefs.

Though the Health and Human Services Department claims that very few women will lose access to their birth control because “a small percentage” will choose to opt-out of the mandate, health policy analysts warn that if employers believe that it will save their company enough money, it might serve as a loophole to deny their employees this coverage.

What some may not realize is that birth control could be normalized in the same way as getting a flu shot, purely because it provides positive externalities. Meaning there are unintended spillover effects that positively contribute to society. Consider the history of birth control: before it was invented, couples tried all sorts of cultural remedies, from crocodile feces in Ancient Egypt to using a half lemon as a cervical cap. Of course, other contraceptives predated the birth control pill, such as condoms and diaphragms, but even then, on average, almost 20% of women would become pregnant despite using them. On the other hand, the birth control pill only has a failure rate of about 6%. What did this mean for American women in the 1970s? The freedom the pill afforded allowed women to get professional degrees and invest in professional, more lucrative careers. Fewer children were being born, which meant fewer lifetime investments and household spending. So what did this mean for America? More money. To put this situation in a more modern context, when the Affordable Care Act was released in 2010, it required companies to use the program to provide birth control for free. In contrast, women could be paying as much as $50 per pack without insurance in previous generations. The result? All taxpayers saved roughly $1.32 bn on average per year, according to a study by Brookings.

This situation doesn’t just apply to US women; it is relevant globally. Unfortunately, about 214 million women of reproductive age in developing countries do not have access to a modern contraceptive method for reasons such as cultural/religious opposition, poor quality of services, or just outright fear. But what could happen if more women in developed nations had access to quality contraceptives? A quick look at Ethiopia will paint the revolutionary effects of contraceptives for developing countries.

In 1990, Ethiopia’s contraceptive prevalence rate (CPR) was a mere 2.9 percent. Furthermore, the country’s total fertility rate (TFR) was an average of 7 children per woman and a maternal mortality rate (MMR) of 1,250 per 100,000 live births. But after a successful introduction of contraceptives, thanks to the cooperation of the Ethiopian government, generous donor support, non-governmental organizations, and public-private partnerships, and a health extension program initiated by the government, by 2011, the CPR quadrupled to 27.3 percent, the TFR dropped to 4.8 children. The MMR also decreased to 482 deaths. In the real world, these numbers translate to more opportunities for Ethiopian women and mothers. Although the rate is still comparatively low, both in sub-Saharan Africa and globally, more than double the number of women from 1990 have more opportunities for mobility. From 1990 to 2011, the primary school enrollment for females more than tripled from 28 percent to 91 percent. The labor participation rate for women increased from 71 percent to 78 percent. Women now control almost a fifth of senior or middle management.

While it’s true that contraceptives may not be the only cause for these changes, it cannot be denied that it is a sizable factor. Contraceptives allowed Ethiopian women to spend less time raising children and doing domestic work, which freed time for education and less labor-intensive jobs that created stability, social mobility, and independence. Ethiopia’s story strengthens the argument that birth control provides women worldwide with more opportunities and allows them to contribute back to their community and their economies, thus improving the overall well-being of their entire country.

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