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I was sitting in the dining hall, laughing with my friends when I got the breaking news alert on my phone from The New York Times: Amy Coney Barrett had been confirmed to the Supreme Court by a narrow partisan vote. Sen. Susan Collins from Maine was the only Republican to vote against her confirmation.

At first, I felt paralyzed. My friends’ words blurred, and I started making plans to get an IUD. There’s a Planned Parenthood about 20 minutes away. I could bike there this week in-between classes. Then, however, I wondered whether an IUD would even help me. They’re linked to irregular periods, and for someone with my condition, that could be fatal.

I have PCOS (polycystic ovary syndrome), a chronic hormonal disorder that causes enlarged ovaries and menstrual irregularity. I need birth control to survive. 

I first learned about periods in fifth grade, when my school packed us all up in a bus on an icy Chicago winter day and shipped us off to the Robert Crown Center for Health Education. Girls in one room, boys in another. We sat on dusty carpeted steps and avoided eye contact with each other as a woman rambled off a speech that she had clearly read hundreds of times. Periods last three to seven days; they come at the same time every month; you might experience cramps but nothing debilitating. She also stressed that periods were something that didn’t get in the way of normal life. I beg to differ.

When I got my first period in eighth grade, it lasted for over 70 days. I bled for almost three months straight, until my annual checkup rolled around. I have a vivid memory of sitting in the pediatrician’s office, terrified because I didn’t know what was wrong with me. The smell of antibacterial soap wafted through the room and the sound of crinkling paper filled the silence as I hopped up on the examination chair. I mumbled what was happening to my doctor, who stopped writing mid-sentence and glanced up at me with an arched eyebrow. Maybe she didn’t know what was going on either, or maybe she didn’t want to scare me, but she just calmly shook her head and told me I should wait a week, and if it still hadn’t stopped, get birth control. It didn’t stop, and it wouldn’t stop for another month, until I finally got my hands on the first pack. After a summer of avoiding swimming pools and feeling incredibly lethargic, the bleeding finally ceased.

Unfortunately, I had lost so much blood — as one does when one bleeds heavily for nearly three months — that I had become anemic. I could barely get out of bed, and workouts that used to be easy would make me pass out. I found out that I was so anemic that I would possibly need a blood transfusion. Luckily, after months of taking two metallic-tasting iron tablets a day, I was able to raise my hemoglobin levels enough to avoid the process. 

Five years, 500-plus days of bleeding, and several bottles of iron pills later, I’m still on birth control. Each time I have experimented with going off it, my period has come back. I often become severely depressed, too.

Even more frustrating than having to change a super-plus tampon every hour, however, was not knowing what was happening to me. I didn’t get diagnosed with PCOS until this past March, after years of scouring the internet for answers revealed to me that my symptoms clearly aligned with the condition: I’ve dealt with painful, cystic acne mostly around my chin; I struggled to lose weight; I grew hair easily; and I had frequent prolonged periods. I begged my mom to take me to another specialist, and they finally confirmed what I suspected. While I didn’t need a diagnosis to tell me that something was seriously wrong, it was nice to know that I wasn’t crazy. My doctor explained to me that since there is no cure for PCOS,  I would need to stay on birth control — which I had no problem agreeing to. So, as someone with extreme menstrual irregularity, I really need birth control.

And yet, even as someone who has access to decent healthcare, obtaining it has often been an uphill battle. When I was 13, my doctor didn’t outright say she was reluctant to prescribe me the pill but I could tell she was. For one, she told me I would only need to take birth control temporarily, because she believed that my menstrual irregularities were due to my age. (While it’s common for girls first starting their periods to experience minor irregularity, mine was more than minor.) She also told my insurance company my reason for taking the pill was acne, a decision that — looking back — frustrates me. Yes, I have acne — but for me, the oral contraceptive is a life-saving medication, not a skin treatment. Over the years, I’ve tried generic and non-generic versions of the pill, and my mom has been left arguing on the phone with the insurance company over the cost. 

I realize that I was lucky to even get birth control in the first place. Many can’t. One in three people aged 18 to 34 have struggled to afford prescription birth control at some point in their life, according to a survey from Planned Parenthood. Black and Latinx communities are disproportionately affected:  57% of young Latinx women and 54% of young Black women have struggled to afford birth control, the survey states. Part of the reason that I started volunteering for Planned Parenthood is because I realized how many other people are at risk when insurance companies bar them from obtaining prescription birth control. The fact that it’s not widely available and accepted is absurd to me.  

So, while I fully expected Amy Coney Barrett’s confirmation, it was still scary to witness. That former Vice President Joe Biden was elected president is a relief, but that doesn’t change the fact that conservatives hold six of the nine seats on the Supreme Court. Barett’s confirmation doesn’t just make the court majority conservative, it makes it majority extremist. 

What’s more, today, the court will begin hearing oral arguments on a case that could overturn part, or all, of the Affordable Care Act. It’s hard to predict the outcome, but given the track records of the conservative judges, it’s possible that access to abortion and contraception is in imminent danger.

An analysis by the National Women’s Law Center showed that the ACA saved Americans $1.4 billion on oral birth control in 2013, and that an estimated 55 million women obtained birth control or other contraceptive services with no out-of-pocket costs. It saved the average woman $255 annually on birth control pills, found a study conducted by Nora Becker for Health Affairs. 

Taking away contraceptive coverage leaves many people unable to afford the medication. And that includes those who, like me, need hormonal birth control as a health treatment — one that can significantly improve the quality of people’s lives, if not save them. In addition to PCOS, birth control can ease the symptoms of other disorders like endometriosis (a condition that occurs when uterine lining tissue grows outside the uterus, resulting in pelvic pain and irregular periods) and premenstrual dysphoric disorder (a condition similar to PMS, but more severe). 

So it’s safe to say I’m terrified. While Barrett has said that the landmark case Griswold v. Connecticut, which legalized birth control in the U.S., “is not in danger of going anywhere,” she’s made it clear she supports limiting access to it elsewhere. During the hearing, she declined to answer a question about whether Griswold was correctly decided, something that even conservative justices in the past have done during their hearings. Not affirming a case that decriminalized birth control speaks volumes to her stance on personal liberty. (Justice Brett Kavanuagh declined to affirm Griswold as well.)  

Even though Barrett remained adamant that there isn’t a foreseeable threat to contraception or abortion access, and though she declined to say how she would vote on hypothetical cases, her past record gives me reason to be concerned. In 2006 she signed a newspaper ad from a radical anti-choice group calling the legacy of Roe v. Wade “barbaric.” Her public support of an extremist group that criminalizes in vitro fertilization and claims life begins at conception makes her stance on the right to reproductive health care clear, and that extends to contraception access. What’s more, in 2012, she signed a petition that opposed the ACA’s birth control mandate, The Washington Post reports, calling the rule a violation of religious freedom. 

This kind of reasoning is behind the Supreme Court’s July decision to uphold the broad exceptions that allow religious nonprofits and houses of worship to opt-out of covering birth control for their female employees. Going forward, Barrett could interfere with birth control access by voting to uphold the Trump administration’s rules and allowing more companies to deny coverage.

If the Supreme Court does choose to modify the ACA in a way that leads to millions of people losing insurance coverage for birth control, I hope that organizations like Planned Parenthood or Power To Decide, a contraceptive access fund, would work to alleviate costs for people in need, as they do now. It reassures me to know that there are people and organizations out there fighting for equal access and extending coverage. But I wish there was no need to fight for access to what is often a life-saving medication. 

I was taught to have faith in the justice system. I was told to trust the process and that if all else fails, Supreme Court justices would rule fairly. I’m starting to realize that, similar to what I learned in fifth grade about periods, it’s just not true. I think they told us these things so that we wouldn’t ask questions. But when my wellbeing and my fundamental rights are in question, I’m not going to stay silent.

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Julia Youman, Khareem Sudlow