Tag : healthcare

January 27, 2021 by

My Anger at the Kavanaugh Hearings Inspired Me to Take Action

Two years ago, I was walking on the street during the Kavanaugh hearings and noticed that almost every woman I walked by was glued to her phone; their faces reflected my disgust and my fear for the future. The brutality of the hearings, the callous dismissal of Christine Blasey Ford’s accusations, the general smugness of Justice Kavanaugh and his elected supporters knocked me back in a visceral way. I finally snapped. 

I needed to channel that frustration and anger into something productive, so I decided to combine that post-Kavanaugh fury with nearly 20 years of work in reproductive health and develop a program to improve access to birth control in rural and underserved communities.  

I went down a rabbit hole of research on models for improving access to such care, and found that in rural communities around the world, mobile clinics are a proven means of delivering care directly to healthcare deserts.  

Next, I needed the where.  

In 2018, four states—Mississippi,  Louisiana, South Dakota, and North Dakota—had “trigger laws,” meaning that if Roe v. Wade is overturned, abortion immediately becomes illegal. More states have since joined them in passing similar legislation. Among them, Mississippi has some of the poorest reproductive health and sexual health outcomes in the nation. In the Mississippi Delta, one of the most rural areas in the state, 62% of pregnancies are unintended and publicly funded clinics are unable to meet 60% of women’s needs for reproductive health care. I reached out to institutions and organizations to understand if what seemed like a good idea in my head—using mobile clinics to increase access to care effectively in birth control deserts like the Delta—would work in the reality of rural Mississippi. I quickly found a community of allies passionate about reproductive health care eager to help launch a new local program in an area where the existing infrastructure is unable to meet the overwhelming need for care.  

Two days after Justice Kavanaugh was confirmed, I founded Plan A.  

Patients living in rural areas are less likely to receive reproductive health care than their urban counterparts. The nation’s healthcare disparities are particularly stark for women of color. Residents of some small towns are forced to travel far distances for healthcare with few or no public transportation options; telehealth is often unavailable due to poor broadband access. Care is prohibitively expensive for the uninsured, or for those unable to afford their deductibles. The legacy of racial and economic injustice in the healthcare system creates additional barriers to care.  

For all these reasons, for the past two years Plan A has focused on residents in the Mississippi Delta. Our conversations with local organizations and community members brought us from an idea into a fully formed organization rooted in the priorities and needs of the community we serve. We are opening our first mobile clinic early next year, expanding services beyond my original plan: the mobile clinic will now offer free birth control from condoms to long-acting reversible contraception, STD and HIV testing, PrEP HIV prevention, and primary-care screening blood pressure, diabetes, cholesterol, depression, and more to uninsured and underinsured residents. And we have plans to expand this program to other high-need areas in the future. 

Political change and advocacy often feel like a devastating game of one step forward, two steps back. 

Working on issues constantly on the precipice—healthcare, social justice, climate change, education—is emotionally and physically draining. When I founded Plan A, I was driven by what a friend called “divine feminine fury.” Unfortunately, that fury is constantly being replenished, although my anger is coupled with excitement for the impact Plan A’s clinic will have on improving access to care.  

The Amy Coney Barrett hearings set off more shockwaves of fear and uncertainty for the future. While politicians litigate the right to reproductive health, women throughout the country face insurmountable barriers to getting birth control. As we rally behind radical change and lobby the new administration, programs like ours will provide essential services to people left out of the conversation. I’m inspired by the momentum created by tangible victories from movements and organizations like Plan A across the country that are improving lives despite the policies crafted to destroy them.  


Caroline Weinberg, MD, MPH, is the founder of Plan A Health. 


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The Lilith Blog

December 21, 2020 by

7 Jewish Feminist Highlights of 2020

Let’s face it—2020 has been a clusterf**k of a year, and I can’t wait to see it recede in the distance of my rearview mirror. While most Jews have observed Passover, the High Holidays, and Chanukah virtually, the national COVID fallout from Thanksgiving, Christmas, and New Year’s is likely to be heartbreaking, even more so given that a vaccine for most of us is just months away. The murders of George Floyd and Breonna Taylor tragically reminded us that we must continue to fight to make the truth that Black Lives Matter self-evident. And among the many, many hits that democracy took this year was the ramrodding of Amy Coney Barrett into the Supreme Court seat that Ruth Bader Ginsburg honorably and notoriously held from 1993 until her death on erev Rosh Hashanah. 

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July 27, 2020 by

We’re Going to Witness a Surge in the Current Health Inequality

MARION DANIS is a physician and bioethicist who directs the Bioethics Consultation Service at the National Institutes of Health. The views she expresses here are her own and not necessarily a reflection of the policies of the N.I.H. or the U.S. Department of Health and Human Services.

The coronavirus pandemic feels like a throwback to an era when human capacity to overcome diseases was minimal. We revert to ageold techniques—isolation, hand-washing, masks. The novelist Orhan Pamuk, who knows a lot about how it feels to live through plagues (he’s read many of the great novels about past plagues as he has been writing a new one), tells us our experience is similar in some ways but different in others. We fear the unknown, we start rumors and blame others for bringing the plague. But unlike the experience of past plagues, we aren’t in the dark; we can know what’s going on everywhere in great detail, and we avoid the full impact of isolation by connecting virtually. We are relying on the biological sciences to eventually find more modern solutions.

In the U.S., the healthcare system will be in a sad state after we have made our way through the pandemic. This will not be solely due to the outbreak but also due to policy decisions made before the pandemic, and during it.

Millions of people will have lost their jobs and will lose their employment-based health insurance as a result. Many people who worked in the gig economy without an economic safety net will be unable to afford the basic elements needed for health, particularly safe housing and adequate nutrition, and will not be able to afford healthcare without incurring debt. Many medical practices will have faced economic hardship and even closed, and healthcare practitioners will have lost jobs because all routine, non-emergency medical care will have gone on hold. We will witness an exaggeration of health inequality because death rates from Covid-19 have been higher among minority communities. We will recognize how important maintenance of public health infrastructure is and what a mistake it was to allow a lapse in preparedness for pandemics.

It will take remarkable optimism to see much good coming out of this pandemic. But perhaps the consequences will be so dire and the urge to fix the problem will be so great that we will urge or even insist that Congress pass legislation to create guaranteed income and expand health insurance, and demand that the executive branch plan better next time. 


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July 27, 2020 by

Abortion for Anyone Who Needs It

STEPH BLACK is a writer, activist and clinic escort in D.C. who is passionate about the intersections of Judaism and feminism. 

Post-Corona, I want to imagine that abortion will be accessible in the ways I’ve always dreamed: The option to seek care in a clinic or self-administer abortion medication wherever a person feels comfortable. The abortion, whether by medications taken at home or by a procedural abortion done in a clinic, will be free. Information around abortion care will be holistic, demedicalized, and demystified.

At this moment, we are at a crossroads. Telemedicine options for many kinds of healthcare have spiked. Yet this has not been true for abortion: the FDA’s stonewalling on accessible abortion medication is baseless. Its refusal to relax medically unnecessary restrictions on the accessibility of these medications is life-threatening to those who need it. As an educator trained on how to self-manage abortion with pills, I know that access to these medications, and information on how to take them, is vital and urgent. Being able to manage an abortion yourself at home during Covid-19 is lifesaving.

Even as more people seeking abortion care turn to this option, I’m hoping others will understand how safe and necessary it is. I envision a time when these medications are available in pharmacies, for free, for anyone who needs it—no questions asked.

Right now, abortion is essential. In a post-Corona world, it must be freedom.

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January 10, 2019 by

In Med School Before Roe v. Wade

We chatted as the dialysis shift began. She was a young nursing student whose name and face I still remember five decades later, but I will just call her “Jane Roe.” She was from the Virgin Islands and had come to New York for nursing school. She was nearly done—justifiably proud, since she had funded it herself. I was a fourth-year medical student doing an elective rotation on what was called the “Renal-Metabolic Ward.” The dialysis machine was working well, so we continued to talk when we could as the hours went by. It was 1968, and dialysis would not be funded in the United States for another half-decade, which meant that any patient undergoing long-term dialysis had to have the means to pay for the treatments, one way or another, or the consequence was obvious—death, since kidney transplantation was in its infancy.

Dialysis shifts were long, and we changed the dialysate fluid (then called the “bath”) halfway through the treatment. We exchanged stories, as students do, about how school was going, what we’d seen on the floors, and what plans we had. Jane said she hoped to go back to St. Croix to serve people in her rural community. She liked it there better than the cold Northeast United States, anyway, she said.

Toward the end of the shift, some alarms on the machine went off, and we all did our part to stabilize the blood flow and the dialysate flow. Nothing so exact as modern hemodialysis, which delivers nearly automatic and precise dialysis care in comparison. But that treatment ended well.

There is another part to this story: Jane, the nursing student, was, in fact, the dialysis patient, and her odyssey had included far more than nursing school. Four months before I met her, Jane realized she was three months pregnant, despite always using contraceptives. She had a fiancé but was not yet married, and neither of them had the means to provide for a baby, so they reluctantly decided that terminating the pregnancy was the only choice. They planned to have children later, when they were both ready and could truly provide what they felt was right for a child. That way, Jane would also be able to continue her training and become a nurse.

So Jane did what thousands of young women were forced to do in the 1960s—she underwent a back-alley abortion. Though she had worried about going through with it, other young women she knew had used the same abortion doctor and had been fine. She went for the procedure with fear but also determination. Unfortunately, afterward Jane was not fine at all: she developed sepsis and multiorgan failure. She survived after weeks of hospitalization and near-death episodes, along the way enduring a hysterectomy and severe acute kidney failure, with bilateral cortical necrosis. Acute dialysis saved her life. However, Jane’s kidney function thereafter was essentially nil, and she continued on thrice-weekly dialysis, donated as compassionate care by the hospital. Jane and her fiancé married while she was in the hospital, hoping that she would gradually improve, receive a transplant, and resume her studies. She told me she was sad that she would never have a biologic child, but she was full of plans for the future.

A few weeks later, another complication developed—acute bleeding, with a hemothorax. I was the medical student on that dialysis shift, too. Jane was too ill to speak, though she was conscious and nodded hello, offering a weak smile. I chatted with her at the start of the dialysis run, but her status deteriorated, rapidly. There was a code. Though the team tried everything they could to resuscitate and stabilize her, she did not make it. We all cried.

Five years later, Jane would not have died—abortion had become legal in the United States. Over the ensuing decades, safe and legal abortion became standard. Thus, Jane would have, like me, become a grandmother, and would probably still be working and serving others.

Why am I telling Jane’s story now? The lack of legal and safe abortion before the Roe v. Wade decision of 1973 killed and maimed thousands of young women. Should that decision be overturned and abortion again become illegal, there will be countless more young women like Jane.

From New England Journal of Medicine, August 23, 2018. Used with permission.

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