Why is birth control an expensive, hot potato issue for the national health care debate and barely mentioned as an environmental problem? My own health issues have led me to new levels of outrage that our government, religious institutions and medical scientists can’t seem to figure reproductive politics out a little better for women or the environment.

Haven’t we got the picture yet? We’re outgrowing the planet!

Gone are the days when I consider the cost of my birth control pills as equal to just another utility bill. Since I’ve had a blood clot, I can’t risk taking them. Also, my mother and younger sister have both had breast cancer. I have too many questions about the effects of hormone subsidies for developing cancer to risk taking the “pill.” Medical science has already discovered that post-menopausal women taking estrogen supplements have an increased rate of breast cancer (although my mother claims it may have been “worth it” for her…). Medical questions about the long-term effects of birth control pills are starting to emerge, but, so far, there is nothing else to replace oral contraceptives for ease, availability and affordability.

Since oral contraceptives are out for me, I decided to try a $700 IUD, but, unfortunately, I let my doctor talk me into a device that also expels progesterone. This IUD promptly caused me to have night sweats, heart palpitations and to gain ten pounds. One hundred dollars later, the problem was removed, and now I face another $700 bill in order to replace that IUD with a non-hormonal copper one. (But at least I’m ten pounds lighter…) My partner, who has not biologically reproduced, hesitates at the thought of getting a $700 vasectomy. If we can save up $2000, then I will have a tubal ligation—an outpatient surgery that, in my opinion, should be free for any woman who wants one.

Even though I’m 44 years-old and have two children, I teach at a Catholic university, so expecting my health insurance to cover these costs is out of the question. The Catholic Church supports the idea of universal health care, but reproductive rights are not part of their spiritual health plan. It seems almost impossible to win the media PR battle for including reproductive rights in a public plan, even though Dana Goldstein identified an important poll in the American Prospectthat claims "71 percent of Americans support coverage for reproductive health, including contraception, under a public plan. Sixty-six percent support coverage for abortion in a public plan."

According to Obama's speech last night about health care, the U.S. may still get some form of a public plan for the uninsured, but federal conscience laws "will remain in place" for reproductive issues. Obama's exclusion of abortion coverage from a national plan is no big political surprise, but the bad news is that the "conscience laws"-- extended under G.W. Bush in 2005-07--support a pharmacist's choice to not dispense contraceptives if they are against the dispenser's "personal beliefs or values."

Pubic coverage of reproductive rights or mandatory dispensing of oral contraceptives may not be the only issue here. Perhaps a better way for the Vatican and some members of Congress to accept improved, reproductive rights as part of the health care debate may be to understand them as environmental issues. As I’ve mentioned before, EPA studies are revealing that endocrine disruptors (partially from oral contraceptives and other estrogen mimics) in our water systems are causing genital deformations in fish and frogs. A new Canadian film, Waterlife (2009), features an indigenous tribal community living along Lake Superior that now clocks in at 70% female. (Sounds like undergraduate university demographics…). Unfortunately, the conservative National Catholic Register uses this disturbing finding as an excuse to justify their Catechism’s interpretation that contraceptives are “morally unacceptable.”

Regardless of your religious beliefs about contraception, the point that the Register's writer makes is clear — neither environmentalists nor EPA officials are likely to jump on the political bandwagon to get rid of the birth control pill since there does not exist any better, cheaper option for women right now. (Lisa Cupido, a Columbia Journalism graduate student points out these contradictions from a more objective perspective.) Environmentalists have realized for decades that uncontrolled population growth affects the environment, and subsequently, the human population negatively. More babies=less food, less water and more damage to the Earth. Environmentalists (and pro-'life' groups) need to demand better, safer, and more affordable birth control options for women. That means more research into the issue, not the abandonment of it.

Fortunately, our Secretary of State has taken on women’s health issues as the serious matter that it is. One of my sisters, Emily Coffman Krunic, works for USAID’s regional conflict office in East Africa. (Hillary is her boss.) Even though reproductive issues are typically handled through government “health” offices, Emily understands that these "women's" issues are also connected to questions of conflict, violence and the environment for women and children. As Nicholas Kristof and Sheryl WuDunn made clear in a recent New York Times article, addressing women’s health, education, and safety is, without a doubt, our “best hope for fighting global poverty.”

Affordable and safe birth control is a key part of this happier picture for the U.S. and the rest of the world. It really shouldn’t be this hard to figure out….