We applaud the Kennebec Journal and Morning Sentinel editorial board for recognizing that the real risk to children born exposed to opiates is not the drugs in their system at birth, but the poverty, hunger and instability that so often accompany life with a parent who is addicted (“Drug-exposed babies another symptom of Maine’s epidemic,” Sept. 15).

It is time to stop the rhetoric and look seriously at what our neighbors need to overcome opioid dependency, have healthy pregnancies and raise children in healthy, safe environments. We agree with the newspapers that women who find themselves pregnant while struggling with addiction need access to quality medical care, including drug treatment, and shouldn’t be made to fear seeking that medical care.

This argument, however, fails to address one crucial piece of the puzzle: Women who are struggling with addiction need to be able to choose not to have a baby in the midst of their struggle. To do so, women need unrestricted access to the most effective birth control methods and to abortion services if desired.

Research demonstrates the significant challenge of unintended pregnancy for women with opioid dependency. These women become pregnant far more often than the general population, and the majority of these pregnancies are unintended.

While traditional methods such as daily birth control pills may not be an effective option for women dealing with addiction, long-acting reversible contraception, such as IUDs and subdermal implants, require no daily attention, are easily reversible and are extremely effective at preventing pregnancy — in some cases, for up to 12 years.

Unfortunately, the one-time costs associated with these methods have left them out of reach for many women. Thankfully, the Maine Legislature recently enacted legislation directing the Maine Department of Health and Human Services to join 28 other states in making Medicaid-funded family planning services available to all women who would be eligible to have Medicaid cover their pregnancy-related care.

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By helping these women avoid or delay pregnancy until they are ready, these services will greatly improve the health and futures of mothers and children, and will save the state millions of dollars in the process.

No one will benefit more from these services than women who don’t want to face an unintended pregnancy while they are dealing with drug dependency. We urge MaineCare to implement the Medicaid Family Planning Option without delay, and to pay particular attention to ensuring that this population is served.

Not all drug-dependent women will access effective contraceptives, however, and unintended pregnancies will continue to occur. For these women in the most desperate of circumstances, abortion must be available, and it must be affordable.

As abortion providers, we all too often speak with women who are facing this situation, but simply cannot come up with between $500 and $700 to cover the cost of the procedure. Despite our efforts to assist in covering costs, too many of these women resign themselves to continuing an unwanted pregnancy in sometimes extremely challenging conditions.

Maine’s policy prohibiting MaineCare coverage for this safe, legal medical procedure for purely political reasons is effectively denying too many women the ability to decide what’s best for themselves and their families. We urge MaineCare to reconsider this denial of health services and join the 17 states that include coverage for abortion services in their state Medicaid programs.

Like all of us, women struggling with substance abuse want to have healthy pregnancies and healthy babies. The average cost of treating a newborn for neonatal abstinence syndrome is $53,000. For 1 percent of that cost, women could have a safe, long-acting, reversible contraceptive method or an abortion for an unintended pregnancy.

We believe, first and foremost, that all women should have the opportunity to decide for themselves about whether to use birth control and whether to carry a pregnancy to term, and that no woman should ever be forced to use contraception or end a pregnancy.

For the women who want these services, however, removing barriers will result in healthier women and healthier families. Women, parents and children all do better when they can access the resources and support necessary for healthy pregnancies and parenting. That’s something Maine can provide.

Leah Coplon and Kathleen Brogan work for Augusta-based Maine Family Planning, a nonprofit whose mission is to offer high-quality reproductive health care, sex education and abortion services and referrals to all Mainers, regardless of income.


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