When US President Donald Trump made it easier for employers and colleges to cut contraception on religious and moral grounds in October, women studying at the conservative University of Notre Dame suspected that their birth control might soon be axed. Weeks later their suspicions were proven right.
On Friday 27 October, the private Catholic university in Indiana emailed its students, staff and faculty to announce that it would drop birth control from insurance plans – becoming one of the first organisations in the US to do so. The email stated that the institution made the move because it "honors the moral teachings of the Catholic Church".
The contraceptive pill works by releasing hormones into the bloodstream, and can be used to stop pregnancy. It also treats conditions including polycystic ovary syndrome and endometriosis. While the university will continue to offer the pill for medical reasons, it won't for pregnancy prevention.
The Affordable Care Act – also commonly known as Obamacare – requires most private health care plans in the US to cover contraceptive methods and services.
This means that institutions such as Notre Dame never paid for student or employee contraception insurance. Instead, the medication is attained through the third party insurer. This gave 55 million women in the US free access, according to the National Women's Law Centre. Following Trump's executive order, religious organisations are able to refuse to allow the third party insurer to independently cover birth control for staff and students.
Emily Garrett, who is reading Gender Studies and co-founded Notre Dame's Feminist society, wasn't shocked by the decision. After all, the university applied to be exempt from the mandate in 2013 and 2012. And on 6 October, Reverend John Jenkins – the president of the college – released an official statement praising Trump's decision to broaden religious and moral exemptions to the contraception mandate.
But they were taken aback by the suddenness of the change, the 21-year-old tells IBTimes UK, as she claims neither students nor staff were publicly consulted.
"The university already doesn't offer condoms or other non-hormonal forms of contraception on campus, nor do they offer a whole lot in the way of sexual education. To rollback birth control care even further is just one more restriction of women's health care on campus."
While the students are not particularly politically active when compared with other institutions, Garrett suggests that women are privately deeply concerned. A vocal minority has chosen to raise awareness of how the changes will affect women on campus, including the independent Graduate Workers Collective of Notre Dame, who last month held a protest at the university.
A women's sexual health and autonomy should not depend on the moral philosophy of her employer or educator
Staff now have around 60 days to find alternative access to the contraceptive pill, while students have until August 14 2018. Luckily for final-year student Garrett, she will have graduated by then – but that doesn't make her any less concerned for remaining students and staff.
If women are unable to find cheaper options with Planned Parenthood, they may have to pay $200 (£150) a month for their medication. That would have wiped out the entire wage of her campus job, says Garrett.
"$200 a month is a unreasonable amount to pay out of pocket for medication," she says. "High prices like this will especially affect low-wage earning staff members, uninsured international students who are pushed to use the University's insurance, and grad students who work on a $23,000 stipend."
"Birth control is necessary for women's bodily autonomy," she continues. "We are allowed to use contraception as birth control; we are allowed to have sexuality just like men, and to act on it, without incurring the risk of pregnancy. Birth control allows us to stay in school, to hold jobs, and to otherwise participate in society without the difficulty of an unwanted pregnancy."
In response, the American Civil Liberties Union last month filed a lawsuit against the government. IBTimes UK approached Notre Dame University for a comment, and was sent a copy of the email that staff and students received.
"A women's sexual health and autonomy should not depend on the moral philosophy of her employer or educator," she says in contrast to the statement issued by Father Jenkins which stated that "no one should be forced to choose between living out his or her faith and complying with the law".
Garrett says that even "devoutly Catholic" friends disagree with this position, and have "responded pretty negatively to the University's decision".
Women are now trying to find alternative modes of contraception, with "a lot" of Garrett's friends considering using an intrauterine device (IUD), or coil, because it lasts for ten years. However, not all women can use this method as it can make periods heavier and more painful.
"Some of my friends are turning to the local Planned Parenthood for more affordable care," she adds.
Asked if she agrees that contraception should be free in the US for women and men like it is in the UK, she says "it would be really nice" and that "it would be a huge step in ensuring gender equity in the US, but I don't think people would ever get on board with it".
"A lot of people don't seem to want to pay for women's birth control despite the fact that it takes two to get pregnant, nor do they seem to understand how vital birth control is as basic healthcare for women's physical and mental well-being."
To those who argue students shouldn't have enrolled at a Catholic college if they expected contraceptives to be provided, Garrett says this is a ludicrous argument.
"Just because my university is Catholic, does not necessarily mean that they must be against birth control. The University of Notre Dame embodies a particularly conservative brand of Catholicism, a version that even its own students find too conservative at times like this."