The Hidden Price of Having a Uterus

As part of She’s Right’s participation in 16 days of activism to end violence against women, each article will be dedicated to a woman who has lost her life due to gender-based violence. This article is dedicated to Milly Dowler, killed by a man on or around 21 March 2002, at the age of 13.

By Rhian Greener.
Edited by Jessica Sutton.

Note: Each of these costs may apply equally to trans men and non-binary people with uteruses.

Period poverty refers to the public health crisis of being unable to afford period pads or tampons. It’s a term that’s become familiar in recent years, with studies showing almost 100,000 girls are at risk of missing school due to a lack of menstrual products in New Zealand alone.[1] But period poverty is only one piece of the very expensive jigsaw that makes up female reproductive health. Regular cervical screening, contraceptive prescriptions, and reproductive health concerns all come at a cost. After a particularly expensive visit to the OBGYN, Harvard T.H. Chan School of Public Health student, Leena Nitin Kulkarni, was prompted to dig deeper into the cost of the female reproductive system, ultimately claiming ‘My uterus costs more than a porsche’.[2]

So exactly how much are we spending on female reproductive health over a lifetime?

Totting up the cost

Before we dive in, it’s worth noting it’s impossible to reach a definitive grand total. There are a whole host of reasons why a woman might visit the doctor for expensive reproductive healthcare, and that’s before we even consider the cost of pregnancy, childcare, and the resulting loss of earnings. We’ll stick to the four most common and everyday costs women encounter in New Zealand here: period products, contraception, cervical screening, and non-serious illnesses.

Period products

As we know by now, the cost of period products is prohibitive for many women. A quarter of women surveyed in New Zealand are unable to afford period products – a situation that isn’t helped by ‘tampon tax’.[3]

In the UK, the tampon tax was finally scrapped in March 2020. After two decades of campaigning by activist groups, the government downgraded period products from ‘a luxury, non-essential product’ to ‘essential’, lifting the 5% tax. It’s about time, considering other ‘essentials’ exempt from tax in the UK include toffee apples, eclairs, and edible flowers…

However, in New Zealand, period products are still taxed at 15%. The average cost of period products is estimated at $30 per month for a New Zealander,[4] and between the ages of 12 and 52, the average woman will have around 480 periods.[5] That’s a lot of tampons.

Lifetime cost: $14, 400 NZD.
(Of which tax: $2,160 NZD)

Contraception

The most common form of contraception in New Zealand is the oral contraceptive pill.[6] The cost of a doctor’s appointment varies widely across New Zealand, but at my local doctors in Wellington, an appointment to renew a prescription for the pill would set you back $56 NZD.

Many pills are funded, and available at the standard $5 prescription rate. However, finding the best combination of hormones for you can require some trial and error. If you’re unlucky enough to need a pill that isn’t funded, you could pay up to $100 for a six-month supply. Or, as is more likely, you’ll accept the cheaper prescription and suffer the consequences – ranging from sore breasts, altered mood, and spotting between periods, to depression, heart problems, and blood clots.

Then there’s the emergency contraceptive pill. Depending on circumstances, you might be able to get this for free / a $5 fee at the family planning clinic. However, if you’re in a hurry, (which frankly, you probably are) there’s every chance you’ll end up paying $35-$50 by picking it up over the counter at a pharmacy.

So let’s do the maths. Assuming you’re on the pill for a conservative 10 years in total, with an annual trip to the doctor and 6 monthly $5 prescriptions, plus at least one emergency contraceptive pill in a lifetime:

Doctor’s appointments: $560.
Prescriptions: $100.
Emergency contraceptive: $35.

Total: $695.

Cervical screening

Women are called for a cervical screening test every three years between the ages of 25 and 70. According to the latest pricing from New Zealand Family Planning, each test costs $40.[7]

Roughly 70-75% of the women called to a screening in New Zealand actually book an appointment. A cervical screening test is an undeniably uncomfortable experience, made even more unappealing by the price tag.

Total lifetime cost: $600.

It’s worth noting there are some fantastic initiatives in place for those who are more at risk of cervical cancer. Government funding exists for Māori, Pacific, and Asian women to encourage screening rates in these groups.

Serious and non-serious health concerns

There are a number of prevalent female health concerns that affect the majority of the population:

Let’s assume our average woman experiences two bouts of thrush in a lifetime, requiring a doctor’s appointment the first time and over the counter medicine the second. We’ll also assume she visits the doctor three times to discuss one other common health or fertility concern.

4 x doctor appointments: $224.
1 x prescription: $5.
1 x over the counter medicine: $30.

Total: $259.

The grand total

The running total stands at a whopping $15, 954 NZD, and that’s before we even consider the prospect of children. The majority of the cost sits with expensive period products, highlighting the importance of initiatives such as free period items in schools, as recently announced by Prime Minister Jacinda Ardern.[12]

The cost of female health is particularly troubling when we consider the gender pay gap. Not only are women lumbered with unavoidable costs as a result of their sex, in New Zealand, they are also typically paid 9.3% less than their male counterparts.[13]

One thing’s for sure, the female reproductive system doesn’t come cheap.


[1] https://www.stuff.co.nz/life-style/well-good/117197654/period-poverty-nearly-100000-girls-at-risk-of-missing-school

[2] https://www.hsph.harvard.edu/news/hsph-in-the-news/calculating-cost-womens-reproductive-health-care/

[3] https://www.newshub.co.nz/home/lifestyle/2018/10/one-in-four-women-can-t-afford-sanitary-items-survey.html

[4] https://philanthropy.org.nz/period-poverty-spotlight-social-enterprises-supplying-essentials/

[5] https://www.nhs.uk/conditions/periods/fertility-in-the-menstrual-cycle/

[6]https://bpac.org.nz/2019/contraception/options.aspx#:~:text=The%20most%20commonly%20used%20form,is%20the%20oral%20contraceptive%20pill.

[7] https://www.familyplanning.org.nz/clinics/fees

[8] https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome#:~:text=Polycystic%20ovary%20syndrome%20(PCOS)%20is,and%20treatable%20cause%20of%20infertility.

[9] http://www.familydoctor.co.nz/categories/womens-health/an-overview-of-vaginal-thrush-candida-a-patients-guide/

[10] https://www.healthnavigator.org.nz/health-a-z/u/urinary-tract-infection-uti/

[11] http://www.familydoctor.co.nz/categories/womens-health/uterine-fibroids-a-patients-guide/

[12] https://www.beehive.govt.nz/release/free-period-products-schools-combat-poverty

[13] https://www.stats.govt.nz/news/gender-pay-gap-unchanged-since-2017


Photo by Reproductive Health Supplies Coalition on Unsplash

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