Certified nurse-midwife Jennifer Love remembers a scene from a training rotation she did many years ago in Cartagena, Colombia, where abortion was illegal at the time. If women came in with complications after a miscarriage or a self-induced abortion, they had to wear a marked shirt and sit in a special area of the obstetric emergency department, where Love worked. “The trauma and the stigma,” she said, “I never thought that we would be moving to where our patients would experience that same sense of fear and shame. It’s terrible. It just breaks my heart.
When University of Connecticut student Natalie Plebanek was 16 years old, she suffered heavy menstrual periods and subsequent fainting spells. But when she asked her pediatrician about a prescription for birth control pills, proven to reduce menstrual bleeding significantly, the doctor balked, citing a common myth. “She thought I would become extremely sexually active,” Plebanek said. Now 21, Plebanek is considering a more convenient method of birth control. Seeking advice from a gynecologist about her options, she was handed a brochure.
It would be hard to find a more successful federal program than Title X family planning clinics. Title X is a nearly 50-year-old federal family planning grant program. According to Guttmacher Institute, the program funds roughly 4,000 health centers around the country, with 4 million clients—including 20 percent of all U.S. women who need publicly funded contraceptive services and supplies. According to Connecticut’s attorney general, some 43,000 Connecticut residents relied on Title X clinics in 2017. Without these clinics, the rates of unintended pregnancy, unplanned birth and abortion in the U.S. each would have been 33 percent higher, while the teen pregnancy rate would have been 30 percent higher.
While we’ve been engrossed in the Republicans’ umpteenth attempt to repeal the Affordable Care Act, the Trump administration quietly has stopped funding 80-some teenage pregnancy prevention programs around the country, including a highly successful one in Hartford. The Trump administration has cut nearly $214 million in grants. Those grants were awarded under President Obama, and were supposed to have ended in 2020. Recently, the U.S. Department of Health and Human Services let grantees know that the funds would end in 2018—two years earlier than promised. The cut was first reported by Reveal, a product of The Center for Investigative Reporting.
Officials at St. Mary’s Hospital and Waterbury Hospital began negotiations in 2011 to merge and join a Texas-owned company. But the state Permanent Commission on the Status of Women—with MergerWatch, a hospital watchdog group—successfully argued against the merger by making the case that since the new hospital would honor Catholic religious directives, a significant portion of patients would be left vulnerable—because God help you if you are a woman and need emergency reproductive services at a Roman Catholic hospital. Medical professionals at Catholic-owned or -sponsored hospitals operate under directives—known officially as the Ethical and Religious Directives for Catholic Health Care Services. These directives come from the United States Conference of Catholic Bishops and take 43 pages (plus footnotes) to describe what constitutes appropriate Catholic health care.
Several times every month, protesters come to the New Haven Planned Parenthood of Southern New England office to hold signs and pray the rosary. Planned Parenthood serves about 64,000 Connecticut patients a year, though according to a recent annual report, abortions are only about six percent of its services. Most of the services revolve around providing contraceptive services and testing for sexually transmitted diseases. Last month, the federal Food and Drug Administration eased restrictions on the so-called abortion pill, also known as RU-486. The new rules allow women to use the drug later in their pregnancies with less visits to the doctor.
For the first time, all Connecticut health insurance companies will be required to cover infertility treatment for people age 40 and older. The state’s Insurance Department said that failure to provide the coverage constitutes age discrimination in violation of the federal Affordable Care Act (ACA). The new requirement takes effect Jan. 1. “Limits to coverage that are discriminatory run counter to the clear intent of the Affordable Care Act and we must ensure that our state laws and guidelines are compliant,” said state Insurance Commissioner Katharine L. Wade.
The Affordable Care Act is providing women with an impressive array of reproductive health care options – except where it doesn’t. Whether a woman is benefitting from the ACA depends very much on her address, and the rather complicated workings of state exchanges. But with some caveats, for Connecticut women, the law is working. We should take a moment to think about that. Connecticut women are in the unusual position of having an important political promise met.