Posted on 10.01.2012 by Kelly
I recently decided that I would like to switch birth control methods, from male condoms to the copper ParaGard IUD. Having recently gotten health insurance coverage after a summer of being unemployed and uninsured, I excitedly searched the list of covered benefits on my insurer's website, certain that the IUD would be included. However, under the category of "Implanted Contraceptives" bold letters read, "Not Covered." This is extremely frustrating, considering that implanted contraceptives, often referred to as long-acting reversible contraception, are the most effective of all contraceptive methods, with typical use failure rates of 0.05-0.8%. Also frustrating is that other than the diaphragm, the only reversible methods covered by my insurance plan are hormonal. The full cost of the ParaGard is $754, which does not include the insertion fee and the cost of associated tests for pregnancy and STIs. This is not something I can afford at this point in time, and considering the alternative of condoms bought online in bulk for around $0.30 each the cost seems even harder to justify. But, considering the efficacy and long-term nature of the IUD, it is a method I would like to use, and I've spent the last couple of weeks calling several clinics to determine eligibility for sliding scales and other programs for a reduced price, which is a work in progress. In the midst of this somewhat stressful process, a number of interesting and heartening articles regarding the IUD have come out recently, further fueling my confidence in this choice as right for me at this particular time in my life.
For your Monday reading pleasure, here are a few such articles:
"IUDs and Contraceptive Implants Safe for Teens" If you haven't heard, the American College of Obstetrics and Gynecology recently released a statement encouraging the use of IUDs by teens, a move that will hopefully help assuage practitioner and patient fears of infertility and other long-term negative effects for people who have never had children.
"Why Don't More American Women Use IUDs?" This article from Mother Jones has some interesting graphs and insights concerning the relatively low rate of US IUD use as compared to worldwide use of the method.
"How can a small piece of copper prevent you from getting pregnant?" I found this recent piece helpful in better understanding how the copper IUD works.
"Switching Contraceptives Effectively" While not talking specifically about the IUD, I found this article to be really helpful and relevant for folks who are looking to switch to a different method.
And finally, this is not new, but I think this comic about one person's experience getting an IUD is really cute.
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Posted on 9.26.2012 by Lily
I found this pretty awesome post recently about how to help a woman in labor. It’s written by a trained birth doula, and I totally want to be a birth doula now too. Besides childbirth just being fucking cool, I’m pretty sure that being with women through labor and delivery would give me mad skills to improve how I help women through their abortions, too.
See, I’m officially a counselor, but I like to think that the term “patient advocate” describes what I do better than counseling. I try however I can to make patients’ experiences with us the most comfortable and positive they can possibly be, and that goes beyond the counseling room. One way I do that is by being a support person through the actual surgery for patients who want it - basically, acting as an abortion doula.
There is no one way that patients experience abortion. As many people as there are who choose abortions, there are experiences with it. And particularly with local (awake) abortions, I’ve been amazed by how dramatically different two people’s experiences can be. For some women, an abortion is intensely painful. Others barely seem to notice what’s going on between their legs. Most, I would say, are somewhere in the middle.
But for every kind of patient, an abortion doula can make an incredible difference. Just as there is no one abortion experience, there is no one way to be a patient’s support throughout her abortion. Some patients want to know exactly what is going on during the procedure, and so I’ll explain every step of the process, what the doctor will do next, and how it will feel. Other patients would rather stay distracted, so we make small talk. Some patients want a hand to squeeze, and I’ll coach other patients on breathing through the procedure.
I try to be there for them before and after the abortion, too. Our rapport begins in the counseling room, but if I can I’ll try to be the one to bring the patient into the OR and help her get set up. It’s nice to have that person be someone the patient already knows a little, rather than yet another new face. And I’ll try to spend some time with them in recovery.
It makes an enormous difference. And patients are incredibly grateful.
Abortion care everywhere should have the doula philosophy at its core. It should underline every. thing. we do.
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Posted on 9.22.2012 by Chantal
In case you haven't noticed, it's election season again. A time to be bombarded with meaningless attack ads, useless speeches, and your Facebook friends' obnoxious political ramblings. Thank god I have Mia at Black Girl Dangerous to keep it real and tell it like it is. This post has been circulating for a couple of weeks now but I thought it deserved a share here as well. For me personally, it most aptly describes how I feel about the upcoming election and about electoral politics in general. This blog is also one of my favorites. It's exciting and inspiring to have found an outlet for radical queer women of color on the internet.
Check it out!
Black Girl Dangerous - When the Lesser of Two Evils isn't Enough
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Posted on 9.17.2012 by Amy
Here comes the biggest repro rights setback to hit Virginia since TRANSVAGINAL ULTRASOUNDS.
The state's board of health has voted to impose hospital-style building standards on abortion clinics, reversing a decision in June that exempted existing clinics from rules governing things like width of hallways and the size.of.the.janitor's.closet.
The move came after strong-arming from the state's anti-abortion attorney general, Ken Cuccinelli, who refused to certify the initial changes exempting clinics and said the board had exceeded its authority. He sent a letter to board members saying they could not exempt existing clinics and warning them they could be personally liable for legal fees if they were sued after refusing to heed his advice. (This is the same state, by the way, where a member of the House of Delegates recently declared that disabled children are God's revenge on women who terminate their first pregnancies.)
Earlier this year I spoke with Rosemary Codding, Director of Patient Services at Falls Church Healthcare Center in Virginia, which, she noted, had a very nice, well-organized janitor's closet.
They'd had to spend thousands of dollars determining whether the clinic could come into compliance with the architectural requirements -- or whether they'd have to close.
The rules in Virginia are part of a rash of TRAP laws across the country that are silently gutting abortion access in this country, clinic by clinic. I discovered how profoundly these requirements were impacting providers when I called clinics to talk about TRANSVAGINAL ULTRASOUNDS and waiting periods -- which were making headlines -- and found them desperate to talk about the TRAP rules -- which were not making headlines.
Continue Reading →
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Posted on 9.14.2012 by Kelly
“I'd have sometimes 4 babies a night...I'd wade in water up over my knees to get to people's houses.”
So Margaret Charles Smith described her work as a midwife, catching 3,500 babies in Greene County, Alabama throughout the early to mid-twentieth century. Margaret was part of a tradition of primarily black healers called “granny” or “grand” midwives who attended to pregnant people in the southeastern United States. As described in a recent article from Insight Magazine, “According to chattel records, the first African (Black) Midwives arrived in America in 1619, bringing with them centuries of healing wisdom from diverse African cultures and their rich traditions of pregnancy care for women. Their knowledge allowed them to continue to care for African and white women in this country and extend this care to include the entire family. African (Black) Midwives not only provided prenatal care and 'caught' babies, but provided primary care for women, pediatric care for newborn infants and children, and medical care for men when necessary.” Grand midwives worked for very little pay and sometimes accepted trades for their services. While maternal mortality rates were high in the early part of the 20th century, there is evidence to suggest that grand midwives had exceptional records. Margaret Charles Smith, for example, did not have anyone in her care die during all her years as a midwife. However, doctors were quick to demonize grand midwives due to their lack of formal education and status as lower class women of color.
While the American Medical Association (AMA) was founded in 1847, professionalization of medicine in the United States did not truly occur until the early 1900's, influenced by studies such as the Flexner Report (1910) which set standards for medical education. Prior to this time there were many quack doctors and snake oil salesmen, but there were just as many lay health practitioners who were knowledeable and competent such as grand midwives, herbalists, and homeopaths. Indeed the treatments preferred by these lay practitioners were often less invasive than those used by the “regular” doctors who were “taught to treat most ills by 'heroic' measures: massive bleeding, huge doses of laxatives, calomel (a laxative containing mercury) and, later, opium.” (Witches, Midwives, and Nurses: A History of Women Healers). A Popular Health Movement in favor of these alternative healing philosophies thrived during the 1830's and 1840's. However, the dominance of the medical model we have today was established by events such as the founding of the AMA, the passage of medical licensing laws favoring “professional” doctors, and the previously mentioned Flexner Report, which was funded by the wealthy Carnegie foundation.
Initially, grand midwives were not seen as a threat to the burgeoning medical profession as the communities they served were largely poor people of color. However, as maternity care moved into the hospital these same low-income people were needed as subjects upon which to train new doctors. Racist and sexist attitudes about the abilities of grand midwives supported the push to limit, and eventually outlaw, their practice. Over the first half of the twentieth century, grand midwives were increasingly required to undergo training and receive supervision from state health departments.
This fascinating movie called All My Babies...a Midwive's Own Story was a training film for grand midwives produced by the Georgia Department of Health in 1952. Through the thinly veiled emphasis on cleanliness and hygiene the movie tells the interesting story of “Miss Mary” Coley and the families she served. Unfortunately many of the older grand midwives were either unable or unwilling to go through the required training and licensing requirements of southern states and were forced to leave midwifery. Eventually many of these states outlawed non nurse-midwives or pushed them into a legal gray area that made it nearly impossible to practice. Margaret Charles Smith was prohibited from practice in Alabama in 1976, when her and “about 150 other black traditional midwives were told they would be jailed if they continued to work as midwives.” (Alabama Women's Hall of Fame)
Today, non-Hispanic black pregnant folks face a maternal mortality rate nearly four times higher than that of white pregnant people. In working to address these health disparities we should look to the model of care that was provided by grand midwives of the past and gain inspiration from amazing people such as Margaret Charles Smith who dedicated their lives to the healing and care of their communities.
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