By: Kyla Horn, Program Manager, AAEKY

In Kentucky, there are over 267,000 women in need living in contraceptive deserts. These are counties that lack access to the full range of birth control methods. All Access EKY is an initiative coordinated by Appalshop, the Kentucky Health Justice Network, and Power to Decide that works within ten Southeastern Kentucky counties to build support for policies, programs and services that ensure young people have access to the full range of contraceptive methods. At All Access EKY (AAEKY), we wanted to examine what other barriers those in the region seeking contraception face. In April, we hosted a virtual focus group for young people ages 17-23 where they shared their personal experiences and thoughts around accessing contraception in eastern Kentucky. Here are some common obstacles shared by our participants:

Clinic hours. Young people, especially those still in school, struggle with finding time to get an appointment. Many clinics close before public schools even let out for the day. You may think college students don't have the same problem, but that is not the case. Even if someone has a couple of hours between classes, that often isn’t long enough to get to a clinic, have an appointment, and get back to class, especially when patient wait times are long.
Lack of anonymity. Small town life means everyone knows everyone. This means that people may avoid accessing reproductive care because they fear running into someone that they know or word of their visit spreading to people they don’t feel comfortable sharing that information with. For example, a young person may avoid getting emergency contraception from the pharmacy because their mom’s friend works there and they don’t want her to see.
Cost. While health insurances cover birth control, there can still be errors and mishaps. One young person shared a story with us about going to the pharmacy to pick up their prescription, but due to a billing error they were asked to pay out of pocket. Fortunately for them, they were ultimately able to fix the issue through numerous phone calls with long wait times. However, some young people don’t have the resources or knowledge to get these issues resolved, and situations like this can deter them from trying again to access contraception.
Stigma. Contraception is rarely talked about, let alone encouraged. Many people in the region only think about contraception in the context of sex, so it continues to remain taboo. Imagine spending so much time building up the courage to go to the doctor to ask for birth control, only to leave empty handed and feeling shunned for having asked.
Sex education. The majority of schools in our region still use an abstinence-only curriculum and fail to properly inform young people about their options. These curricula are not medically accurate or age appropriate; rather, they use scare tactics to steer students away from sex. With nearly half of the pregnancies in women aged 15-44 being unplanned, maybe it’s time to think about whether this is still the best option.

Wondering what you can do to help reduce some of these barriers and increase access to contraception in Appalachia? Here are some suggestions!

Are you a provider? Visit Bedsider Providers (sign up here for our newsletter) to stay in the know about new research, methods, and clinical perspectives. Get certified in One Key Question®, a patient-centered framework for healthcare providers, social service providers, and champions to routinely ask their patients about pregnancy desires and goals and offer personalized counseling and care.

Are you a young person? Visit Bedsider.org, the world’s largest online birth control support network. Download the Bedsider Reminders App to get daily, weekly, or monthly reminders based on the form of birth control you use. Check out BCBenefits, a contraceptive access fund, to see if you’re qualified for free birth control!

If you live in Kentucky and are currently uninsured (or do not want to use your parent’s insurance), you could be eligible for:

a free virtual birth control visit with one of our telehealth partners and a free one-year supply of the birth control pill mailed directly to you
reimbursement for an in-person visit with any health provider to get the birth control method of your choice
free roundtrip ride to cover travel to and from an in-person appointment

If you live in Kentucky and are currently insured, you may qualify for:

a free roundtrip ride to cover travel to and from a birth control appointment with your healthcare provider

To learn more about or sign up for BCBenefits at: https://www.bedsider.org/where_to_get_it/bcbenefits/about

To learn more about AAEKY and to stay up to date with our work, be sure to visit our website at https://www.allaccesseky.org/ .