Residents lead campaign advocating for universal, no-cost contraception

Residents in our Department are leading a grassroots campaign to advocate for universal, no-cost contraception for everyone living in Ontario.

Cover ContraceptiON is a volunteer-led organization of medical professionals, community members, and students from across the province that is chaired by Dr. Nour Bakhache and Dr. Hava Starkman, PGY3 residents in our Department.

After officially launching on Sept. 26, 2020 — known as World Contraception Day — Cover ContraceptiON has since grown to include more than 80 volunteers spread across Ontario while making real progress toward their policy goals. In addition to being formally endorsed by the Ontario New Democratic Party, Bakhache and Starkman recently met with Ontario Health Minister Sylvia Jones to discuss the benefits of having no-cost contraceptives added to the provincial budget.

“It definitely seems like the universal contraception movement is gaining momentum, and I think the level of interest from the government demonstrates that momentum,” Starkman said.

“I think people are realizing that universal contraception would not only be cost-beneficial, but more importantly, that it is something that would really improve the lives of people across Ontario and across Canada.

“The time to implement this is definitely now, and there’s no reason in our opinion that this can’t or shouldn’t be done.”

To a certain extent, Cover ContraceptiON originally grew out of the hardship of the pandemic.

In an atmosphere of economic hardship and precarious employment, many people were losing access to health benefits and were no longer able to afford contraceptives. Further, as stay-at-home guidelines left families unexpectedly spending months together in close quarters in the home, there was concern around increasing rates of interpersonal and domestic violence.

Newly enrolled in our residency program at the time, Bakhache and Starkman felt passionately about raising awareness of the issue.

“To us, this was really an issue of reproductive justice and autonomy, and the empowerment of women in the context of what was happening around the world,” Bakhache said.

Since launching, their focus has been to build a strong network of volunteers across Ontario — not just the Greater Toronto Area — while generating as much media coverage as possible around the importance and potential positive implications of no-cost contraception.

Our residents have now given interviews advocating for the cause with a number of top media outlets including CBC, TVO, and the Toronto Star. They’ve been grateful for the attention, as well as the support they’ve received at all levels as they’ve worked to push the issue forward.

“With us being residents, the work we have done wouldn’t have been possible without the support of the residency program, staff, and the program director, Dr. Michèle Farrugia,” Bakhache said.

Cover ContraceptiON organizers have been encouraged and motivated by the success of their sister group in British Columbia, AccessBC, whose campaign ultimately resulted in the B.C. government pledging $119 million in funding for free prescription contraception over the next three years.

In looking for motivation to continue advocating for this important cause, though, they ultimately do not need to look far.

“The biggest motivator for me is sitting with patients and seeing the impact of the cost of contraceptives every day,” Bakhache said.

“The day that B.C. announced they would be providing free contraceptives, I sat with a patient in clinic who needed contraceptives due to a number of medical complexities. We talked through many different options and their pros, cons, and price points. She ultimately had no choice but to just choose the cheapest one. The fact that she couldn’t get the best treatment for her, strictly because of cost was very impactful to me, and it just emphasized how much Ontario needs no-cost contraception.

“Every day, we’re seeing the impacts of this. So I know that the time is now for free contraception — and it’s been that way for a long time now.”