With President-elect Donald Trump promising to "repeal and replace" Obamacare, many young women are afraid of losing an important benefit — the ability to get all forms of contraception with no out-of-pocket cost.
Their fear is evident on social media and blogs, where women frantically advise getting an intrauterine device — a high-cost option that, by working for five to 10 years, could outlast a Trump administration.
"But seriously, get an IUD right now," a University of Pennsylvania nursing school administrator posted on Facebook, linking to a blog titled "Here's Why Everyone Is Saying to Get an IUD Today."
So far, there is no stampede for IUDs or other long-acting forms of birth control, according to a sampling of local colleges and universities, women's health clinics, and Planned Parenthood.
But inquiries are way up.
"I polled our nurses and the other nurse practitioners, and all report having had a significant increase in questions about IUDs in the past week," said Perri L. Stella, a nurse practitioner in the University of Pennsylvania's student health service.
"I would say definitely the number of calls about IUDs has increased tenfold," said Dayle Steinberg, CEO of Planned Parenthood of Southeastern Pennsylvania.
The level of angst is also high. Stephanie Routson, a nurse practitioner at Planned Parenthood's Center City clinic, which provides abortions, noted in a blog that Trump has said women should be punished for having the procedure if it becomes illegal. "Where does this leave the millions of women we serve?" Routson asked.
Routson also declared in the blog post that since the election, her office has been "inundated with women coming in to have IUDs placed" — meaning, Steinberg clarified, that there were many inquiries, not actual procedures.
The contraceptive benefit is one small part of the Affordable Care Act. This year, the American College of Obstetricians and Gynecologists (ACOG) worked to update the ACA's provisions that cover contraception and other women's preventive health needs.
"We know that improving access to and knowledge about long-acting reversible contraception methods may decrease unintended pregnancies, abortions, and adolescent birthrates," Eve Espey, chair of the organization's contraception work group, said Wednesday. "I can understand women's concern over losing such access, particularly to high-cost methods."
The ACA's contraceptive mandate has had a huge impact, according to the Guttmacher Institute, a reproductive health research center that supports abortion rights. The share of women who got the pill at no cost rose from 15 percent in 2012 to 67 percent in 2014. Women who used long-acting methods — injections, the vaginal ring, or IUDs — saw similarly big increases.
If the contraceptive benefit goes away, women without insurance would typically pay $20 to $50 a month for birth control pills. An intrauterine device and the procedure to insert it can cost up to $1,000 — a hefty out-of-pocket expense.
That's why Sarah Houghton, 37, of Wilmington, has made an appointment at her local Planned Parenthood affiliate to get an IUD.
"Like a lot of women, I've been really scared since the election about the possibility of Obamacare being overturned. I rely on it for health care," said Houghton, who works for a small nonprofit. "I've been using the birth-control pill. I'd been thinking about switching but probably wouldn't if the financial aspect wasn't a concern."
Jennifer Hayes, 28, of Center City, has talked to her doctor about switching from her existing IUD — the Mirena brand, which lasts up to five years — to Paragard, which lasts up to 10. It's a way, she said, to protect her reproductive control, if not her health-insurance coverage.
"After the election results, I was devastated," Hayes said. "Because of the political climate, I feel like my uterus is not my own."