Well-Being//

I’m an Abortion Provider in a State with Limited Women’s Health Care. And I’m Anxious.

A Planned Parenthood director reveals the worries of her colleagues—and patients—as the makeup of the Supreme Court is about to change.

	Atomic Imagery/Getty Images
Atomic Imagery/Getty Images

I am proud to serve as the Associate Medical Director for a Planned Parenthood affiliate that serves three midwestern states. But I would be lying if I said the Trump Administration’s anti-women’s health agenda, and the most recent Supreme Court news, haven’t brought many new challenges. And with new challenges come new worries.

I love my job and I love caring for my patients. Nothing changes that. But as providers doing this work because we believe in everyone’s access to good health care, my colleagues and I are especially concerned about the patients who may not realize what’s at stake. Especially in medically underserved states like North Dakota and South Dakota, where access to health care generally, and women’s reproductive health care specifically, is very limited. It’s common for people to not fully understand the laws and policies around abortion access until they themselves need an abortion. Then, they’re astonished at the hoops, delays and extra steps they have to take in order to get the care they need. These are the patients that keep me up at night—the patient who suddenly can’t afford her birth control because it’s not covered; the patient who may not need an abortion today but will in the future.

The Trump Administration is determined to use women’s health care as a political pawn to score points with its supporters with no regard for the impact on real people. For example, immediately after the election, we started to receive many anxious calls from patients who were truly terrified that they were going to lose their health insurance and their access to birth control. We saw a sharp rise in women seeking long-term options, like intrauterine contraception (IUDs), and every day the number of appointments grew. My patients were telling me things like, “I need birth control that’s going to outlast the President,” and “If I’m going to lose my health insurance, I need an IUD so I can get through the next four years.” We saw a 60 percent increase in the number of IUD appointments in the two months after the election.

Our patients had every right to be worried. And, we, their health care providers, were worried with them. About 40 percent of our patients use private insurance and many of them were newly insured under the Affordable Care Act. Trump and his allies in Congress were trying to repeal the Affordable Care Act and block tens of thousands of patients in Minnesota alone from receiving health care at Planned Parenthood. These bills also would have blocked patients who are insured by Medicaid from being cared for at Planned Parenthood even if they had no other provider in their community. While Congress tried to repeal the ACA three times, the good news is that Americans came together as a united front and stopped them. Three times, women, men, doctors and nurses stood together across the country and defeated these bills. That was no small feat. It shows how when we fight back, we can make a real difference.

And now, President Trump is planning to appoint a Supreme Court justice who is set on undermining the right to safe and legal abortion in our country. At the same time, the Trump Administration is working to cut Planned Parenthood from another funding stream: Title X, a bipartisan family planning program that has provided affordable birth control and other preventive health care since President Nixon sat in the Oval Office. None of these Title X federal dollars are ever used for abortion services, yet the Trump Administration is trying to stop these funds from going to any organization that provides or even discusses abortion as an option. In practice, this would mean that Planned Parenthood would have to withhold information from a patient about her pregnancy options. My colleagues and I would never agree to do this. This move wouldn’t stop abortion. In fact, it could very well drive up the number of abortions because fewer people would have access to affordable birth control.

So, once again, if the Trump Administration succeeds in their most recent attack on women’s health, the people most hurt would be our patients. The women who called us immediately after the election for an IUD were right to worry. But what about low-income women who can’t have an IUD because it doesn’t work for them for one reason or another? If Title X funding is cut, these women will have few birth control options if they can’t afford the full cost of birth control pills, patches or rings.

Every day I watch these threats to women’s health and consider that the Supreme Court may shift dangerously, giving future generations fewer rights than we have today. But I also see the faces of my patients and I see my colleagues, who are so committed to our work. While I share the fear our patients are experiencing about their health care, that anxiety helps fuel me and makes me more resolute in our mission and purpose. We are very aware that many people we serve have no other health care options, especially in small towns where Planned Parenthood is often the only health care provider for birth control.

No one works at Planned Parenthood by chance—everyone who works at this organization cares deeply about the health of women and families. We won’t leave our patients, especially during these trying times when women’s basic rights are being threatened across this country. I will be here for the people who need my care and I know my colleagues will be too, no matter what. Every time I think about what the future might hold, I remember that Planned Parenthood has been here for 100 years. We’ve weathered attacks and always come out stronger on the other side. While the fears and anxiety ebb and flow depending on the political environment—the fight is in our DNA. Regardless of what this Administration brings, we will be here for another 100 years.

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