In post-Roe America, we hear often of the heart-wrenching losses caused by policies that take away the right to abortion. Amber Thurman, an aspiring nurse who arrived at the hospital with a treatable infection and never left because Georgia law had made a routine procedure a felony. Samantha Casiano, whose baby was given a fatal diagnosis at 20 weeks, who was forced to stay pregnant, hearing congratulations from strangers for months while planning her baby’s funeral. Nevaeh Crain, a teenager who died of sepsis because doctors were too afraid of being imprisoned for life to interfere. 

These stories embody the fundamental violence that is restricting abortion. People circulate these reports widely, hoping to appeal to moderates. Surely, they beg, you cannot be OK with a law that produces outcomes like this.

We have to share those stories, because the policymakers responsible do not deserve to go one day without being reminded of what they have done. 

Yet the inadvertent effect of the national conversation largely focusing on these worst cases — the kind that anti-abortion extremists still insist can somehow be solved with narrow legal definitions that doctors will be apparently able to interpret while their patients are turning blue — is that we lose sight of the essence of reproductive freedom. If there can be any meaning to these meaningless, abjectly cruel events, it is not “OK, we’ll make exceptions for women who are saints and prayed for children and did everything right and are still actively dying.” It is that every adult deserves the dignity to make decisions about their future. 

Every reason for getting an abortion is equally valid, regardless of how distasteful or sympathetic you personally find the particular circumstances. No matter how the fetus was conceived, no matter what protection they did or didn’t use, no matter if they’re nonchalant about having an abortion or in tears in the waiting room. 

The same rhetoric around why sexual freedom matters, to a less dire extent, seems to be trickling down into conversations around birth control. As a college student, I get the sense that my peers are pretty comfortable talking about birth control. They announce when their daily reminder to take the pill goes off, joke about the blanket-sized list of side effects and, importantly, are open to sharing their experiences in medical settings, both positive and negative. 

Yet when the topic of hormonal birth control does come up, they’re still quick to emphasize all the non-sex reasons they use it.

To be sure, countless women — myself included — benefit from birth control’s many other uses, from reducing cramps, making periods more regular and treating acne to slowing the progression of endometriosis and its excruciating symptoms. For some people, these are key medical interventions, and it’s great that more people are talking openly about it.

Still, the narrow publicly acknowledged reasons for taking birth control sometimes come across as hasty assurances that preventing pregnancy is the furthest thing from someone’s mind. This is despite the 95% of sexually active women on birth control who report taking it for contraception and the 65% who aren’t having sex currently but still say that’s why they use it. People are shy about admitting they use birth control for sex, because our society — particularly in recent years — does not talk about sex as a normal and fun part of life. 

This emphasis on physical over sexual health in the rhetoric around birth control is, I think, related to those same restrictions on reproductive freedom. In trying to protect its accessibility, well-meaning people highlight all the medical reasons birth control might be needed. But the unintended implication is that taking it for specifically sexual freedom isn’t as essential a reason. 

It’s hard to overstate how much the birth control pill transformed life. Leaving the workplace after getting married was no longer inevitable for women, who could now take a tiny pill and build a career, then decide if they wanted kids. Couples had fewer unplanned pregnancies, leading to fewer rushed marriages. The pill made our modern social structure possible.

There is nothing shameful about using birth control for birth control. You don’t need to be suffering to deserve hormonal contraception. Let’s celebrate it — birth control lets people have sex with fewer worries about getting pregnant, and in the context of human history, that’s an unbelievable achievement.

You shouldn’t feel like you have to tell people you’re just taking birth control for cramps if you’re taking it so you can have safer sex. You shouldn’t feel like you have to tell people why you’re taking it at all, of course, but if you choose to, why not be honest — casual about it, even — with people you trust? 

A strong reproductive freedom movement must include the essential medical applications for birth control and abortion, and it must include the millions who simply can have sex without fear because of it. And our country’s caginess about sex will never change until we start talking about it.

Write to Livia at [email protected].