I 

came from a family where we were raised with the 
wait until marriage, none of that stuff, don’t even 
think about it,” LSA senior Emma Cheff began, 
responding to the question of why she sought out prescribed 
birth control.
“And so, I didn’t really know how to get birth control. I 
didn’t know how it works — honestly, I didn’t know anything 
until I had to go through Relationship Remix, which was 
really sad.”
Her junior year, Cheff began the process of figuring out how 
to access birth control. If she relied on her parents’ insurance, 
the bills would immediately disclose the prescription, but 
paying for the contraception out of pocket was not an option.
“I’m first gen,” Cheff said. “My family doesn’t make a lot 
of money. I’m working to pay through school. I don’t have 
money to pay for birth control every month.”
Luckily, through much research, Cheff learned she could 
access birth control and stay on her parents’ insurance by 
having the billing information sent to her instead of her 
parents. She then consulted with University Health Service 
medical professionals to find the birth control that worked 
best for her. 
Contraception is widely used on the University of 
Michigan-Ann Arbor campus. According to the 2018 
National College Health Assessment administered by UHS, 
87 percent of students used some sort of contraception 
during their most recent vaginal intercourse. The usage of 
long-acting reversible contraception such as the intrauterine 
device and the implant, which are considered most effective 
due to their long-lasting and user-independent nature, are 
increasing steadily. In 2014, 10 percent of students used 
LARC during their last intercourse. This rose to 23 percent 

in 2018. 
UHS is constantly striving to make 
contraception available to students, 
as well as to help students find 
what’s right for them. They recently 
implemented video visits as an option 
for contraception consultations. For 
students who have questions about 
health insurance, they have a Managed 
Care/Student Insurance Office. 
And yet, the barriers remain. Students face financial, 
educational and cultural obstacles, stigmas about their 
sexualities and gender identities and concerns about birth 
control impacting their mental health. Each student has 
their own story — their own “unique mix of barriers,” as 
UHS health educator Laura McAndrew put it. How can UHS 
maximize support for all these students?
“I don’t have money to pay for birth control 
every month”
S

tudent 1, a Kinesiology junior who requested 
anonymity as she did not wish to publicly come out 
as queer, found herself in a bind last summer when 
her health insurance suddenly stopped covering her. 
As a person from a low-income background, Student 1 
was covered by Medicaid. But due to a glitch in the system, 
her insurance wasn’t working. She had a birth control 
prescription from UHS, but without health insurance, she 
would have to pay out of pocket. 
“I was trying to find places that were the cheapest that I 
could buy for because $20 to me is a lot of money,” Student 
1 said. “Whereas I know to some of my friends and family 
members, it’s just a drop in the bucket. But for me, the first 
prescription that I was on was $70 out of pocket per month, 
which is absurd.”
Ultimately, she managed to scrape together enough money 
to purchase the student health insurance plan. The first 
thing she did was switch to an IUD, so she would not have to 
pay for birth control consistently.
“I switched to an IUD because I don’t have to pay for it 
month after month after month,” Student 1 said. “So now I’m 
baby-free for the next five years, hopefully.”

McAndrew said UHS tries to tackle the financial barrier 
in a few ways. The costs of different contraceptive methods 
are on the UHS website, and McAndrew said students are 
welcome to visit her or other Wolverine Wellness staff to 
think through their options. If students have concerns about 
using their family’s insurance plan, UHS can put information 
about that in their after-visit summary. McAndrew further 
encouraged students without health insurance to visit the 
Managed Care Office.
Susan Ernst, chief of gynecological services at UHS, said 
one option they point patients toward is accessing birth 
control pills from local pharmacies, many of which have 
steep discounts. 
Another challenge is figuring out loopholes to get 
insurance companies to pay for contraception, Ernst said. 
She said sometimes insurance companies will pay for IUDs 
if they’re billed through the UHS pharmacy rather than 
their medical office. 
If none of these options work, Ernst said they will refer 
students to Planned Parenthood, which offers contraception 
on a sliding price scale based on income. This is best for 
students who want an IUD or implant, she said. 
“So, some of our students who have absolutely no income, 
they can get the IUD for pretty cheap,” Ernst said. 
McAndrew emphasized UHS is always looking for ways to 
improve their system.
“We know that this doesn’t account for all circumstances,” 
McAndrew said. “I would really welcome ideas about how to 
better support students with the cost barrier, because I think 
it’s really important.”
“It’s very much taboo to talk about any sort 
of sexual, reproductive birth control”
R

ackham student Jess Hernandez first went on birth 
control as an undergraduate at Michigan State 
University. She said as a Mexican American, birth 
control was a taboo topic in her household.
“I identify as Mexican American, and so, in our culture, 
it’s very much taboo to talk about any sort of sexual, 
reproductive birth control,” Hernandez said.

Wednesday, December 11, 2019 // The Statement
4B
5B
Wednesday, December 11, 2019 // The Statement

See BARRIER, Page 6B

“A unique mix of 
barriers”: What 
stands in the way 
of students getting 
birth control?

BY ELIZABETH LAWRENCE, 
MANAGING NEWS EDITOR

ILLUSTRATION BY MAGGIE WIEBE

–––

SEX 
SURVEY
DATA ANALYSIS BY PARTH DHYANI, ALEX 
COTIGNOLA AND TIM CHO, WEB DEVELOPERS

The Michigan Daily conducted 
their annual sex survey, which 
was completed by a total of 592 
undergraduate students across 
colleges at the University, to 
gauge knowledge and habits 
regarding sex. 39.4 percent of 
respondents identified as male, 
58.9 percent identified as 
female, 1.3 percent identified 
as non-binary, and less than 1 
percent identified as other.

The Daily was particularly 
interested in examining usage, 
knowledge and impressions 
behind 
contraceptives, 
in 
context of the role that the 
University plays in providing 
resources 
and 
information 
about contraceptives. Check 
out the results below!

