According to the World Health Organization: “Sexual and reproductive health problems are responsible for one third of health issues for women between the ages of 15 and 44 years.” Considering all of the possible health issues in humans, one third for sex and reproduction is a lot. And what’s more upsetting is that we know quite a bit about preventing and treating sexual and reproductive health problems, but too often women still do not receive or have access to the care they need. Too often women do not have the power to choose what’s best for them and are told what to do instead.
It is important to note that this statistic is for women worldwide, but we can’t just sit back and think to ourselves that the US has it all figured out either, because we don’t — women in our country are suffering from problems related to sexual and reproductive health.
In this day and age, we have the science and medicine available to help women take control of their reproductive health, and they should always have the opportunity to choose what’s right for them. In order to fully exercise their rights guaranteed in the US — life, liberty, and the pursuit of happiness — women need to have reproductive freedom. We should be able to choose if and when we become mothers. We should have complete access to reproductive health care choices — everything from preventative health care to screenings to treatment; from contraceptives to assisted reproductive technologies; from prenatal care to maternal care; to pregnancy termination.
Fortunately in this country, the Affordable Care Act had started to address some of these problems; it made historic gains regarding women’s health care, both in terms of more people receiving coverage and in terms of what services are covered by insurance.
The Affordable Care Act (ACA) tightened regulations in the insurance business in order to better protect and serve the patient. As a result, health care coverage was expanded to many Americans who were previously not covered, including young adults who preferred to stay on their parents’ plans. The ACA made it illegal for insurance to be denied to people with pre-existing conditions, helping all kinds of people receive insurance, including women who were previously denied coverage for pre-existing conditions such as having had a c-section or being the victim of domestic violence or sexual assault. The ACA made gender rating illegal — insurance companies can no longer charge women more for insurance than they charge men.
And under the ACA, insurance companies are now responsible for covering an impressive list of preventative health services. For women specifically, services that are now covered by insurance include:
- “Well-woman visits.
- Gestational diabetes screening.
- Domestic and interpersonal violence screening and counseling.
- FDA-approved contraceptive methods, and contraceptive education and counseling.
- Breastfeeding support, supplies, and counseling.
- HPV DNA testing, for women 30 or older.
- Sexually transmitted infections counseling for sexually-active women.
- HIV screening and counseling for sexually-active women.
- Mammograms and Colonoscopies”
As this new coverage rolled out, US women and girls finally began to have access to and coverage for some of the health care they needed.
However, even with all of these positive changes, women’s health care still has room for improvement (e.g., cancer, mental health, violence against women)… but I am very afraid that our health care situation is about to get a lot worse, instead of better. Right now, many of the reproductive choices that we currently have in the US are at risk of being taken away — the new administration does not support women’s rights or women’s health. The combination of the new administration, the new congress, the rise of Catholic hospitals, and the increase in Targeted Regulation of Abortion Providers (TRAP laws) have all put women’s healthcare in the US and abroad in serious peril.
Under the new administration, the Affordable Care Act is at risk of being repealed, and no one has any idea of what it might be replaced with, if anything. This means that in the future women’s health care plans could again become more expensive than men’s, people could be denied coverage, preventative services and medications may not be covered anymore, and so on. This is scary. And women know it. After Trump was elected, women were rushing to obtain long acting birth control in the fear that contraceptives will no longer be covered once the new administration gets their hands on the ACA.
On top of that, the House of Representatives is currently considering a personhood law (H.R. 586) which defines human life and personhood beginning at the moment an egg has been fertilized, and it states that all laws pertaining to people should apply to the fertilized egg. This law would ban abortion, major forms of contraception (including IUDs, Plan B, and possibly the ring, injectables, the patch, and even the pill), and potentially IVF. It could also open the door to prosecuting women who have experienced a pregnancy loss, and since about ¼ of confirmed pregnancies end up in miscarriage or stillbirth, that’s a horrifying prospect. Personhood laws like this are a major attack on women’s health and reproductive choices.
Every woman should have the right to choose whether or not to pursue pregnancy. For those who want to avoid pregnancy, contraception should continue to be available to each and every woman who would like it. If the ACA is repealed, new regulations and coverage must continue to provide this vital type of care. Choosing if and when to become a mother is critical for women to thrive.
And for those of us who would like to be pregnant, we should have the right to pursue it, even if we suffer from the disease of infertility. In the case of infertility, pursuing pregnancy may require assisted reproductive technology (ART) (e.g., IUI, IVF, and/or third party reproduction). Therefore, personhood bills should never be passed because they will interfere with ART, and insurance companies should be held responsible for assisting with fertility treatments. Currently, fertility assistance and ART are not covered by most insurance policies. We, for example, have no insurance coverage for fertility treatments. Those of us struggling with infertility should be able to count on insurance to assist us in building our families. And before getting upset about the high costs of fertility treatments, please keep in mind that pregnancy and delivery carry an extremely high cost, at times even far exceeding that of an IVF cycle. Insurance companies could certainly cover ART, but they won’t until someone makes them.
In addition to choosing if and when to pursue pregnancy, women should be able to access the comprehensive care they need. Unfortunately however, in some areas of the US, access to some types of care is a major problem due to Catholic hospitals and TRAP laws.
In places where Catholic hospitals are the only option, many women are denied the care they desperately need because it conflicts with religious beliefs of the hospital system. Catholic hospitals are notorious for refusing medical treatment to women requesting services like contraception or sterilization, or who urgently need pregnancy termination due to dangerous miscarriages or ectopic pregnancies. While some hospital systems are bound to be worse than others, it is never responsible or humane to treat women like our reproductive health is something that doesn’t deserve medical attention.
In general, access to pregnancy termination is a problem in the US, even though abortion has been a legally protected right in the US since 1973. In some states increases in restrictions through TRAP laws have made it extremely difficult for women to terminate unwanted, problematic, or dangerous pregnancies. In addition to TRAP laws, a personhood law and/or a new appointment to the supreme court could tip the balance away from the court’s continuing to uphold the right to have an abortion. As a result, access to pregnancy termination could be eliminated, putting many women at risk of everything from an unwanted pregnancy to a life threatening situation — there are many reasons why a woman may seek an abortion and she should have access to one if it’s the right choice for her. A pregnancy should not be more highly valued than the life and decisions of a woman.
Sometime after my ectopic pregnancy, I realized that there were people who didn’t support my right be treated and even hospitals who would have turned me away. I realized that if I still lived in my hometown where the local hospital system is Catholic, I would not have been allowed to terminate my ectopic pregnancy with methotrexate. Instead, they may have waited for the pregnancy to grow to the point of rupturing my fallopian tube, putting my life in danger, or they may have removed my entire fallopian tube prior to a rupture. The Catholic church and other anti-choice supporters actually believe that I murdered my child; but I completely disagree: I humanely ended a pregnancy that would never have been able to survive in my fallopian tube, while protecting my own health and safety — ectopic pregnancies can be extremely dangerous. It’s terrifying to me that some people controlling healthcare value a non-viable pregnancy more than the life and well-being of a woman. Sometimes pregnancy termination is the right choice for a woman to make. It was for me. And it has been for others too. (e.g., here and here)
Unfortunately, the problems with women’s reproductive health care that we are seeing here in the US are not in isolation; Trump has already reinstated the Mexico City Policy which affects healthcare providers and women around the world. The Mexico City Policy prohibits recipients of US foreign aid (even if it’s private) from providing any and all abortion related services, even information about abortion. Health care providers who refuse to sign the agreement will lose all US funding and all donated contraceptives, including condoms. This policy adversely affects women around the world by taking away their reproductive choices in multiple ways. After Bush reinstated this policy in 2001, affected countries saw a more than doubling of the abortion rate due to a decrease in comprehensive care. Our president should have nothing to do with restricting the health care choices of any woman, in our country or abroad.
It is also likely that the new administration will cut funding for the Violence Against Women Act (VAWA). This isn’t exactly reproductive health care, but it is certainly a part of women’s health, so I’ve decided to include it as well because it’s important and close to my heart. Programs under the VAWA include services for preventing intimate partner violence and supporting survivors of violence, sexual assault, and stalking. Cutting these programs would have a disastrous effect on the 1 in 4 women in the US who are victims of intimate partner violence. We need to end violence against women, not leave victims to suffer at the hands of their perpetrators.
I am so disappointed and horrified that women’s health is being so viciously assaulted. These organizations and politicians have no respect for women’s lives or decisions. As someone who has used contraceptives, terminated an ectopic pregnancy, and is about to undergo IVF treatment, I feel personally attacked by these people who are trying to take away my reproductive choices — they should have NO SAY on what happens inside my body or anyone else’s.
I know I’m not alone in feeling like this — on January 21, women in the US and around the world marched and demonstrated to protest the president and to demand equal rights, health care, and reproductive choices, in addition to many other things. It was the largest protest in US history and I hope elected and appointed officials were paying attention. I hope they heard our voices. And if not, I’m prepared to march again, and again, if necessary. I am prepared to write to my representatives again, and again. I’m prepared to demand equal rights and reproductive freedom.
I truly hope that one day we live in a world where everyone has the healthcare they need and the power to make the choices they want, but we are not there yet… We need to keep moving forward and build on what we have. We need to work together and make our voices heard, and our elected and appointed officials need to listen and represent us the way they are supposed to. We are counting on them to empower everyone with health care options and reproductive freedom — they are vital to fully exercising our rights to life, liberty, and the pursuit of happiness.
To write to your Representative, please visit: http://www.house.gov/representatives/find/
To write to your Senator, please visit: https://www.senate.gov/senators/contact/
To write to the president, please visit: https://www.whitehouse.gov/contact
While Matt and I have been lost in the terrible land of infertility, we’ve been the ones guiding our loved ones through it at the same time. As I’ve mentioned before, not many of our loved ones have experience with infertility and loss, so they are often unsure of what to say or how to support us. I so often hear that someone doesn’t know what to do, or doesn’t know what to say, or doesn’t know how to help, or doesn’t want to do something in case they hurt my feelings, and so on…
So many times when someone we love is upset, we try to make them feel better. We don’t like it when someone is hurting or sad, and we try to fix it. So we might suggest ways for them to look on the bright side, or give them tips on what we have done in that situation to make things better. I think we all do this at times, myself included. And I think for the most part that this is ok. It seems natural to want to help and many times we are very capable of helping a loved one feel better about something or working with them to solve a problem.
