Nov 8, 2023

Democratizing Access to Birth Control with Dr. Nap Hosang (podcast)

The freedom to create a family when and how you wish is an important component for human flourishing.

By Templeton Staff

One of the important components to living a flourishing life is having the freedom to choose when, if, and how to plan a family, says Dr. Nap Hosang. The doctor, featured in this episode of Stories of Impact podcast, is a retired obstetrician and gynecologist who spent more than two decades practicing in California while teaching family planning and maternal mortality reduction at the School of Public Health at UC Berkeley. Each year, there are roughly two to two and a half million unintended pregnancies in the United States, says  Hosang, and there are numerous obstacles hindering ease of access to reliable contraceptives for women, from high cost to lack of places to acquire them. Along with his colleague at Berkeley, Dr. Malcom Potts, Hosang co-founded Cadence OTC to address this pressing issue. Cadence OTC's mission is to increase women's, and all people's, access to safe, affordable birth control pills, without a prescription, regardless of their zipcode, income level, or insurance status. With support, in part, from Templeton World Charity Foundation, Cadence Health has been working with the US Food and Drug Administration (FDA) to gain approval for Zena, a combination oral contraceptive (two-hormone pill) to be sold over-the-counter in the United States.

Listen to the episode with the above player to learn more.

Key Takeaways:

The Challenges
Hosang points out that unintended pregnancy "significantly changes the life trajectory" of women under the age of 20. "In this capitalist society, the acquisition of knowledge, further training, finished schooling, college education are important qualifying steps for people to get ahead. And for many who have an early pregnancy — especially ones that are not planned and are accidental — it puts a wrench in the spoke of the wheel. They have to stop what they're doing to attend to the important business of raising a child. And that also has impacts on their child's ability to complete a secondary education. We know that the people, for instance, who get pregnant before they finish high school, their children, the children of those pregnancies actually also have difficulty completing secondary education."

Cadence is committed to addressing cost concerns that prevent many from access to birth control in the US. Notably, these financial hurdles are most prevalent in areas with lower household incomes and in rural regions. Hosang describes the emergence of "healthcare deserts," which encompass areas with limited access to healthcare services, a situation that he says also extends to "contraceptive deserts," where birth control outlets or clinics are few and far between. Furthermore, he notes, "there are about 7 or 8 million women who don't have health insurance. That includes a few million women who are undocumented. At the moment, if you don't have insurance, you can't get a prescription unless you go to a public clinic and seek it that way." These challenges highlight need for transformative solutions.

Birth Control and Contribution to Family Life and Flourishing
Hosang emphasizes that access to birth control is not only about preventing single motherhood, it's about the freedom to plan. Birth control, he says, is "in fact, a huge contributor to family life, for those family units who don't have access to healthcare insurance who would desire to have an active sexual life without the fear of an unintended pregnancy." he points out that "ever since it was released back in the 1960s, the Pill has been used mostly by women who are married. And today, there are many families — married individuals with children who want to space their children, who want to limit the number of children that they have — who take a risk for not being able to protect themselves from an unintended pregnancy."

Play the episode to hear:

  • What Hosang's mother said that inspired his quest.
  • How Cadence wants to "make available to women the same pill that they and their doctors have decided to use over the last four decades, the two-hormone pill." This is different than the one-hormone pill (or Opill) that was approved by the FDA in July 2023. While Opill is progesterone-only, Cadence's Zena contains both estrogen and progesterone to prevent ovulation and pregnancy.
  • How with a customized app, Cadence is addressing the FDA’s concerns, moving the project closer to approval.
  • How Hosang believes Cadence’s success in the United States could make a global impact.

Learn about the research projects related to this episode here and here.

Built upon the award-winning video series of the same name, Templeton World Charity Foundation’s “Stories of Impact” podcast features stories of new scientific research on human flourishing that translate discoveries into practical tools. Bringing a mix of curiosity, compassion, and creativity, journalist Richard Sergay and producer Tavia Gilbert shine a spotlight on the human impact at the heart of cutting-edge social and scientific research projects supported by TWCF.