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Harsh Words, and Women’s Health at Risk

I’ll open with a confession –

Women’s health has never really been at the heart of ML. Your author has, his­tor­i­cally, rel­e­gated sub­jects like normal men­stru­ation, healthy preg­nancy and repro­duction and natural menopause to her gyne­col­ogist friends. Sure, I learned about the facts of life. I even studied them in med school and answered ques­tions, some cor­rectly, along the way. By now, I’ve lived through these real life-​​phases directly. But these topics never drew me. That’s changed now.

Women’s care – and lives, in effect – are jeop­ar­dized on three fronts:

First, on birth control. Last week the Senate nar­rowly tabled a move to limit insurers’ respon­si­bility to cover con­tra­ception. The vote on the so-​​called “con­science” amendment was 51–48. What this tells us is that essen­tially half of that pow­erful group either agrees with lim­iting women’s access to birth control or sees it as dis­pensable in the context of political aims.

The very fact that the pro­posal reached the Senate floor is dis­turbing. Without access to birth control, women —  including teenagers, people with sig­nif­icant medical problems that can be exac­er­bated by preg­nancy, those who can’t afford to feed another child, and some who are already troubled or oth­erwise might not be ready or pre­pared to have children — are much more likely to become pregnant. It shouldn’t take a doctor to artic­ulate this obvious point, and I can’t under­stand why so many are silent on it, but since so few physi­cians and the AMA in par­ticular hasn’t issued any statement on this, I’ll stick my neck out and say it clearly: Lack of con­tra­ception puts women and their con­ceivable future-​​kids at risk for health problems that could be avoided.

The lan­guage sur­rounding the amendment is prob­lematic, besides. Who are the anti-​​birth control legislation-​​writers to imply that “con­science” is involved in with­holding con­tra­ception, and not the other way around? It’s like the “pro-​​lifers” who’ve implied that the rest of us aren’t.

Second, on access to safe abor­tions. I respect that some people think it’s wrong to ter­minate a preg­nancy. But I also know that plenty of women, espe­cially young women, get pregnant who don’t want to be pregnant. Regardless of who’s “respon­sible” – and any reader of this blog knows I’m no sucker for finger-​​pointing and behavior blame games — the bottom line is that if abor­tions become out-​​of-​​reach, women will suffer hem­or­rhage, life-​​threatening infec­tions, per­manent infer­tility  and pre­mature deaths.

Hard to know how many women had ill effects or died from botched abor­tions before January, 1973, when the Supreme Court issued its decision on Roe vs. Wade. Like most women of my gen­er­ation, I know of those unfor­tunate out­comes only indi­rectly. Still, I can’t rid my brain of the scary, unclean place Natalie Wood visits with a wad of cash in the 1963 movie Love with the Proper Stranger, or the tragic outcome when actor Gael García Bernal takes his pregnant love to an abor­tionist in the film Crime of Padre Amaro, set a decade or so ago in Mexico. But the real scoop comes from older physi­cians and nurses, here and now. When I was in med school in the 1980s, they told me stories of women and girls showing up in the emer­gency room bleeding, pale… dead.

As out­lined by edi­to­ri­alists and writers else­where, mergers of Catholic hos­pitals with other medical centers threaten to reduce or elim­inate access to abor­tions in some rural areas. In states like Texas, the physical and emo­tional rig­marole to which pregnant women are sub­jected prior to an abortion – including mandatory lis­tening to a description of the fetal organs and a dis­cussion loaded make what might be a tough decision unbearable, espe­cially if the woman lacks confidence.

Which leads me to the third point of vul­ner­a­bility - that women should be able to obtain care without intim­i­dation or emo­tional abuse.

When Rush Lim­baugh spoke last week, he wasn’t just talking about one Georgetown Law student. He was speaking to and about mil­lions of young women who are sex­ually active. He called them sluts and insin­uated they are like pros­ti­tutes. Adding insult to verbal injury, he said he’d like to watch videos of the sex. You could say who cares, he’s just some right-​​winged showman blowing off steam and misogyny. But this is a man who speaks to con­ser­v­ative leaders and feeds ideas to many house­holds in America. Scary that the Repub­lican front-​​runners, men who would be Pres­ident of the United States next year, didn’t call Rushbo out. Rather, they let it go. As they might your daughter’s health, or access to birth control, or to a safe abortion.

In this new climate of shame, it’s easy to imagine a girl in some com­mu­nities might feel really, really bad about herself simply for being sex­ually active. Whether she’s 17 years in high school, or 21 years in college, or 25 and maybe a department store clerk – and pos­sibly lonely or con­fused — she may be embar­rassed to ask for birth control. The Scarlet C, Robert Walker aptly called it yesterday.

The paradox is that this kind of rough talk, pos­turing and in some states, puri­tanical law-​​making, make it more likely that a sex­ually active young woman will become pregnant. And if she does become so, now, she may delay seeing a doctor because she fears his or her moral judgment about her behavior. And that leads to less healthy out­comes, and more deaths – fetal and maternal.

This is a serious health issue. I wish more doctors would speak out about it.

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5 comments to Harsh Words, and Women’s Health at Risk

  • Elaine —

    These are indeed fright­ening times for women. The backlash on Lim­baugh is loud and well-​​deserved. Thank you for so elo­quently defining the issues.

    Peggy

  • Well said. Thank you for being the voice of reason on these threats. I too wonder why more physi­cians are NOT speaking out, loud and clear, on these three pro­foundly important issues facing American women’s health care. By com­parison, a quick scan of sites like kevinmd seems to suggest that docs don’t seem shy about voicing their views en masse about issues like EMRs and Rate Your Doctor sites and threats to net income from health insurance reim­burse­ments that are too low.

  • JustAWoman

    As a woman, not some doctor princess, I am very much aware that birth control is not the end all be all to birth control. As an aunt, friend, business pro­fes­sional, Catholic and much more, I rec­ognize that a number of indi­viduals who have had birth control fail, resulting in a mul­titude of off­spring! The advance of birth control allows men to be as horny as hell, and control when a women has and does have sex, all 30 -/​+ days of the month. Whereas the more natural birth control methods advo­cated by nat­u­ralists and Catholics, results in the factor that women are IN control of their bodies and their hus­bands at all times. Yes, a women, can have an abortion, but then again, those who do, have an increased for suicide and pro­longed depression. All the way, karma is a bitch.

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