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Health Reform and Women's Access to Care

By Carol Duh-Leong

As a female physician-in-training, there is no moral issue as fraught with anxiety and self-reflection as the one of abortion. As we enter our journey into medicine, we swear to leave our assumptions and personal experiences at the door in order to serve our patients first. After serving terms as both school president of the American Medical Women’s Association and as chair of Medical Students for Choice, I have entered countless discussions with my colleagues about how challenging it is to feel like we can do it right, and this is why it’s hard: Access.

As we move into the wards and our discussions turn from philosophical to practical, what we experience firsthand is what one case-worker told me after managing women’s access to care for twenty-five years. “The rich get richer, and the poor have children.” In this day and age, with so many contraception options, it’s so easy for the public to be judgmental towards women who end up with an unwanted pregnancy. Still, when you meet these women face to face, you meet the frightened fifteen-year-old girl who puts on headphones, closes her eyes, and cries through the entire procedure and realize with frustration later that she lives in a community where birth control is truly folklore because of cost. There’s the twenty-one year old who comes in for a late-term abortion because she started saving money for a procedure when she found out she was pregnant, and this is how long it took her. Unintended pregnancies among poor women is twice the national average. Abortion would be a simpler issue to debate if it was not so entrenched in poverty and access.

This is why the Friday announcement is so awesome. The Obama administration announced that soon women will not have to pay out of pocket for birth control. On August 1st, many insurance plans nationwide will be fully required to fully cover contraception without co-pays or deductible. Increasing access to birth control is phenomenal and allows women to be empowered with the care of their own body and plans for their family.

 Announcements like these are what make the Affordable Care Act so pivotal. Its very existence allows us to redefine the priorities of the health care system. It forces us to re-examine the system, and to advocate for the changes that we need.


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