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Esmée Zwiers is an Assistant Professor and researcher at the Amsterdam School of Economics. She has investigated the link between the availability of the birth control pill in the Netherlands and the economic position of women in society. What does this mean for the current generation of young women, which seems to be turning away from hormonal contraception?

The birth control pill was introduced to the Dutch market in 1963. At that time, the packaging did not indicate that the product could prevent pregnancy, Zwiers explains. 'The Netherlands was characterized by conservative Christian norms before the sexual revolution: advertising contraceptives was forbidden. The pill was marketed as a medication that could regulate the cycle, and temporary infertility was only mentioned as a side-effect. To avoid tempting workers to engage in immoral behavior, packaging the pill was even outsourced to a nunnery when demand increased.'

'Significant improvement in the position of women'

Esmée Zwiers examined how improved availability of the birth control pill from the early '70s influenced the economic position of women in the Netherlands. The effects are substantial, as described in a recent article she co-authored with Olivier Marie from the Erasmus University Rotterdam.

'Women who had access to the pill at younger ages were more likely to delay marriage and motherhood compared to women who gained access at later ages. They also invested more in their education, performed better on the labor market, and accumulated more wealth in the long run.' The research was recently cited in an ESB article, a Demos article, and a podcast. (all sources in Dutch).

Price of the pill has an impact

Today, obtaining a prescription for the pill is quite straightforward. Not all barriers have been eliminated however, as Zwiers explains: 'Statistics from the Rutgers Foundation show that in 2017, 34% of young sexually active women did not use contraception. Of that group, 2% mentions the costs of contraceptives as the reason for not using contraception. Additionally, a survey executed by Doctors of the World indicates that especially economically vulnerable women would prefer using a different contraceptive method than the one they are currently using if they could afford it.'

Relevant legal case

So, a financial barrier to using the pill continues to exist. For the Bureau Clara Wichmann, an organization dedicated to improving the legal position of women, this has been grounds for legal action to force government to include the birth control pill in the public health insurance package.

But price is not the only factor

Hormonal contraceptives such as the pill are currently under pressure for reasons unrelated to price. A recent NOS article highlights that fewer young women use hormonal contraceptives. A fear of hormones – ‘hormone phobia’ – is said to underlie this trend, fueled in part by content from influencers on social media. Doctors indicate though that pregnancy risk is higher for alternative ‘natural’ forms of contraception, such as periodic abstinence.

'Contraception is important for women'

Zwiers’ research shows the important role the pill has played for women: 'Preventing unplanned births using the birth control pill has had significant consequences for women since the 1970s. Today, 50 years later it will be interesting to see if ‘hormone phobia’ will lead to more unplanned births in the coming years and if so, how that might influence women’s educational and labor market opportunities.'