(Elizabeth Gabriel / WFYI) Using birth control is life or death for Kendall Hantelman. She was diagnosed with a bleeding disorder due to her excessive menstrual bleeding and a near-death hemorrhage after a sinus surgery. When she was 23, her doctor said she had a 25% chance of dying if she got pregnant. “So, I started taking birth control to stay alive because the doctor told me that I would have better odds playing Russian roulette than getting pregnant,” Hantelman said. She eventually got her tubes tied, a surgical procedure that permanently prevents pregnancy, but she went into ovarian failure –– a rare complication from the procedure. Nearly 20 years later, she still relies on a hormonal birth control pill. “So, now I have to take birth control again because my body doesn't make hormones anymore,” Hantelman said. Contraceptives like birth control pills, IUDs, emergency contraception, arm implants and the vaginal ring are used to prevent pregnancies. But they do more than that. In fact, one in seven women who use contraception use it for non-pregnancy related reasons — like managing and treating blood disorders, endometriosis and other diagnoses. But birth control has become a hot-button issue embroiled in political debates and misinformation, which worry reproductive rights advocates about what the future may hold for people’s access to these medications. Protections for birth control Sarah Slater, 32, got her period when she was just 9 years old. Slater had excruciating cramps and often changed pads in the middle of the night due to heavy bleeding. Misinformation about birth control prolonged Slater’s pain. “My doctor wanted to put me on birth control, but my mom said no because birth control is for sex only,” Slater, who lives in the small rural Indiana town of Montpelier, said. “So, I wasn't able to get on it until after I had my son. Because after I had my son, I bled for almost a year and had really bad periods.” There are over-the-counter anti-inflammatory pain medications to treat period cramps and other symptoms, such as the popular brand Midol. But half of girls and women who took those medications still had severe pain after a few hours, according to recent research, which is why some rely on birth control. Slater was later diagnosed with endometriosis, a chronic condition that causes tissue to grow outside of the uterus causing inflammation and scar tissue in different parts of the body. She’s had multiple surgeries to reduce the number of cysts on her ovaries. The use of birth control has helped manage multiple reproductive health issues and curb symptoms related to heavy period pain. Slater’s experience with birth control misinformation echoes experiences that still go on up to this day. A recent survey shows that 17% and 39% of doctors from different specialties believe an intrauterine device, or IUD, and emergency contraception cause abortion, respectively. But these contraceptive tools work by preventing fertilization and conception in the first place, according to the World Health Organization. Still, misinformation continues to fuel political debates and influence lawmakers, said Laurie Sobel, an abortion law and litigation legal analyst with the nonprofit health policy research and polling organization KFF. “I think really a lot of this comes down to the misinformation about the definition of contraception versus abortion,” said Sobel, who is also an associate director for Women’s Health Policy at KFF. Sobel said abortion bans across the country have led to the spread of misinformation about birth control, with some lawmakers and conservative groups conflating contraceptive methods with abortion. She said this may threaten access to birth control. “At the state level, we're seeing other types of laws that could ultimately infringe on the right to contraception,” she said. This year, lawmakers in 13 states introduced bills that could give rights to embryos and fetuses that are generally given to a person, according to an analysis by the Guttmacher Institute, a non-profit that supports abortion rights. Sobel said the prospect of such laws coupled with the misunderstanding that contraceptives induce abortions, could impact access to birth control. Just 14 States and Washington D.C. have legal protections to the right to contraception. Concern for the future of contraception Debates around contraception in the U.S. have existed for decades. In 1965, The U.S. Supreme Court ruled that married couples are allowed to use birth control without government restrictions under the Griswold v. Connecticut case. Seven years later, the Eisenstadt v. Baird case protected single women’s access to birth control. But some worry the tides may be changing, especially since the U.S. Supreme Court overturned Roe v. Wade in 2022, ending federal protections to abortion rights. One month after that happened, Democrats introduced a bill that would ensure access to contraception nationwide. All but eight Republicans voted against it. Some Republicans said they supported the use of contraception but worried that the Democrats’ bill could be misconstrued to allow abortion or that the definition of contraceptives could be interpreted to include abortion pills. At least 17 states have tried to protect birth control and in 2024, federal legislators introduced the Right to Contraception Act but these efforts have also been blocked by Republican lawmakers. (Elizabeth Gabriel / WFYI) That worries birth control users like 26-year-old Asche York. As a baker, they often lift 30 pounds or more of liquor boxes and dry goods like sugar, flour and cornmeal. Blackouts from period pain caused York to lose a job and fail college classes. Now they would be at a loss without the contraceptive arm implant they got about four years ago. “I wouldn't be able to live a decent life,” York said. “I don't want every time I try to enjoy my life or improve my life to backtrack because I'm in bed for eight days.” Too soon to worry about access? The 2024 election cycle and results have left people like York fearful for the future. Now that there is a Republican trifecta in Washington, advocates say birth control may be the next frontier in the fight over reproductive health care access. Some point to Former President Trump’s first term, when his administration allowed employers with religious objections to exclude coverage of birth control from their employees’ health insurance policies. But some lawmakers think the concerns about potential restrictions on access to birth control are premature and blown out of proportion. Sue Glick, a Republican Senator for Indiana’s District 13, is anti-abortion rights. She wrote the state law that banned abortions after Roe v. Wade was overturned in 2022. But she also sponsored a bill to allow Indiana residents to access birth control without a prescription and supported a bill that required hospitals to offer subdermal birth control to people after giving birth. She doesn’t think state or federal lawmakers will limit birth control access in the future. “I just don't think that the general attitude of the American people, and certainly, Hoosiers, is to control everyone [or] every aspect of everyone's life,” Glick said. “I have not heard Republicans, Democrats or anyone else talk about banning birth control. I just haven't heard that. I don't know where that's coming from." However, Glick doesn’t foresee an Indiana lawmaker proposing a bill during the upcoming legislative session that would codify the right to birth control in the state constitution. But she’s not opposed to the idea. (Elizabeth Gabriel / WFYI) Still, some medical providers are worried, like Maram Said, a minimally invasive gynecologic surgeon in Indiana. She said her views do not reflect her employer. She works at a Catholic hospital in a suburb outside of Indianapolis, where she is not allowed to prescribe certain types of birth control. That’s why Said works for a small clinic where she independently prescribes birth control for women who need it for a variety of family planning and medical reasons. She lists birth control as a necessary medication in her patients' charts. It’s an extra step she now takes in case lawmakers restrict access to contraception in the future. “I would never want to take away from a woman's ability to have a healthy life,” she said. “And she may choose to be a mother by adoption or other modalities or have a gestational surrogate carrier because it's safer for her body. But we also want to protect her body, and I would never want her to be anemic from periods or to have other medical implications of not being on birth control.” Contact Health Reporter Elizabeth Gabriel at [email protected]. Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky. Copyright 2024 Side Effects Public Media