#MeToo in Women’s Healthcare

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The #MeToo Movement, in regards to sexual harassment, has created a great awakening in our country as to what we have tolerated in the past and what we are willing to tolerate in the future. This powerful movement needs to extend beyond just sexual harassment and into other platforms that are unique to women but have been controlled by men. One of these areas is women’s healthcare policy, a sphere that has been traditionally dictated by men as the people in positions of power in government  that make the decisions around funding and laws.

Two conversations with patients this week made me realize how far we have come in women’s healthcare over the past 10 years …. and how far we have backtracked in the last year. A new patient in her early 20’s presented for discussion of contraceptive options. After reviewing the pluses and minuses of each contraception method, I realized that her job was with Hobby Lobby. This is one of the businesses that have used the religious objections to birth control by their founders to justify that they will not provide coverage of contraception to employees who use employer-provided healthcare. Although many forms of hormonal contraception are used for non-contraception reasons, these are also not covered. Luckily the patient was well aware of these limitations and had remained on her parents insurance plan for this reason.

The second patient was an immigrant from Liberia and delivering her first child. When the baby was born she and her husband informed the delivery room staff and their family that the baby was being named after the husband’s sister – a woman who had died in her late 20’s of an illegal abortion in Liberia, leaving behind 3 small children. That same week, CNN published an article with the statistics that only 1 abortion clinic exists in Kentucky and the governor is working hard to outlaw abortion in the state. With 47% of pregnancies in Kentucky being unplanned and the teen birth rate 68% higher than the rest of the country, it does not seem that the women of Kentucky are being served well by their male governor.

The most effective way to prevent abortions and reduce the teen pregnancy rate is providing education and free or reduced cost access to contraception. Statistics prove that contraceptive education does not increase teenage sexual encounters but does reduce the teenage pregnancy rate.  When teens in a rural area of Colorado were provided with contraception education and free access to long-term contraception (Nexplanon or IUD), both the teenage pregnancy and abortion rate declined by almost 50%, saving the state $70 million in public assistance.

The current administration is attempting to take away the gains that were made in women’s health care over the previous 8 years by limiting funding for sex education, removing contraception as a required insurance benefit and pushing the anti-abortion agenda to include the persistent attempts at de-funding Planned Parenthood. This affects not only women but also their partners. We need to use the tidal wave of the #MeToo movement to include a push back against the current culture of anti-women healthcare policies that have been put into place by male legislators. Speak out, call and write your legislators, donate money. But don’t be SILENT. We have seen the power of our words changing a culture of sexual harrassment and we know that a long history of silence didn’t effect such a change.

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Teen Pregnancy in Africa

imageAs I have been traveling thru Kenya for the past 2 weeks, I have seen many boarding schools for both boys and girls and also many children’s homes for orphans.  But when a teen girl becomes pregnant, often against her will, there are few options.  If the father and his family are willing, she can marry.  Abortion is illegal. Becoming a single parent brings shame on your family and often cancels your chance of future marriage.  When the founder of Imara first thought of establishing a home for unwed mothers, she found no resources available.  No hits when she googled teen pregnancy and Kenya.  18 months later she has 8 girls and 7 babies, with one expected any day.  The future plan is for 50 moms and babies.  The need is great and the options for these women few.  I have been given permission to share some of their stories with names changed.

Christine was given to her husband in marriage at age 10 or 11.  Shortly thereafter, her parents died and she was not allowed to go to the funeral by her husband.  She gave birth to her first child at age 12, delivering at home with the help of her mother in law. By age 14 she was pregnant with her third child and suffering from daily beatings, inflicted by both her husband and her mother in law.  In the middle of the night she made the decision to run away, not knowing where she would go and having to leave her 2 young children.  She traveled for 3 days by foot, sleeping in a tree at night.  After arriving at a neighboring village, a kind older woman took her in and fed her.  This same woman had heard of Imara House and contacted them.  Christine delivered her child shortly thereafter and is a good mother to her third child, while she is only 15.  She does not know what has happened to her other children and worries that her husband is now abusing them.  She is slow to smile and one of the quietest girls at the home.  She is only know starting to feel safe enough to voice some displeaure with certain rules.  While I was visiting, we sat all the girls down and had a frank sex education course.  Most of them were too embarassed to ask questions so we met with each of them seperately.  With downcast eyes, she softly asked her question.  “Do I ever have to have more children or get married?”  At the age of 15 she wishes to be done with childbearing and cannot imagine a loving relationship with a man.  The goal of Imara House is to provide these girls with a high school education and a marketable skill so that they can provide for themselves and their child.  Future marriage and children can be their choice, not a decision that was forced on them at all too young of an age.  

 

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