Tomorrow – Free Webinar for Family Planning and Primary Care Providers

Photo courtesy of nih.gov.

Photo courtesy of nih.gov.

The Illinois Medicaid Program recently released a major new policy on family planning, including increased rates for certain procedures. Illinois Healthcare and Family Services is offering a free webinar on Wednesday, December 3 at 1 p.m CST. This interactive session will assist both family planning and primary care providers to take advantage of this new policy for their clients by synthesizing and presenting the most valuable current data and best practices in family planning. Register now.

Dr. Melissa Gilliam Featured in AP News Story on Contraception Access

AP Photo

Section Chief Dr. Melissa Gilliam was featured and quoted in an Associated Press news story regarding Illinois’ recent effort to ensure comprehensive and continuous birth control coverage for those with Medicaid.

The story, which has been picked up by outlets nationwide including CBS News, discusses a plan from Illinois Gov. Pat Quinn’s administration to improve access to family planning services for individuals with Medicaid, including long-acting birth control methods, by increasing reimbursement and education. The plan was announced at last month’s Illinois Contraceptive Equity Summit, an event hosted by the Section and EverThrive Illinois. The public is invited to comment on the plan until September 15.

According to the article, the current Illinois Medicaid payment system creates a financial barrier to doctors for offering LARC methods. For example, IUDs cost doctors’ offices between $300 and $800 each to keep in stock. Clinics pay the upfront cost of an IUD and absorb the loss of denied or delayed Medicaid claims. By implementing the Illinois Family Planning Action Plan,  the state would double doctors’ reimbursement rates for inserting IUDs and performing vasectomies, thus alleviating the cost for both patient and provider.

Dr. Gilliam commented on access to contraceptive methods within Medicaid, saying that “for some providers, [the state’s plan] will make a very big difference and will be a very welcome change.”

Photo: M. Spencer Green, AP

Section and Ci3 Launch Online Access Guide

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In the fall of 2012, the Section of Family Planning and Contraceptive Research, Ci3 (the Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health), and the Urban Initiative of the National Institute for Reproductive Health held a roundtable discussion at the University of Chicago to explore the status of abortion access in the region. More than 50 participants working in fields connected to reproductive health, rights, justice, and well-being joined the discussion. Several key proposals to improve abortion access emerged over the course of that day.

One such proposal was the development of Accessing Abortion in Illinois, a guide for health and social service providers so they can help navigate clinical, legal and financial barriers to abortion access in Illinois.

Talking about getting an abortion can be difficult, which can make actually obtaining one even harder. Recent study findings suggest that two out of three people who have an abortion anticipate experiencing stigma if others were to learn about it. In a large national survey, 58% of those seeking abortion felt they needed to keep their abortion secret from friends and family and 17% believed their regular healthcare provider would treat them differently if they knew about the abortion. At the same time, states have introduced a record number of abortion regulations in the last few years, making it more complicated for individuals considering abortion to navigate access and financial obstacles.

Yet, despite stigma and regulations, one in three women will have an abortion in her lifetime. Pregnant persons seek abortion for a wide range of reasons, and often consider many personal factors when making their decision. Health and social service providers are uniquely positioned to counsel individuals who are thinking about abortion and make sure they have the information, support, and resources to get the care they need. For example, individuals commonly consult with a primary care provider to confirm a positive pregnancy test, seek options counseling, or obtain referrals. Pregnant persons may also turn to social service providers such as social workers, case managers, counselors and ministers for help in making a decision about a pregnancy and to find information about abortion care. In Illinois there are fewer than 40 providers offering abortion services and 92% of Illinois counties have no provider. As a result, health and social service providers can be critically important in connecting individuals with abortion care.

Accessing Abortion in Illinois was made possible through the support of the National Institute for Reproductive Health.

We welcome your feedback! Once you have visited the site, please fill out a short survey about your experiences.

“Cookies and Conversation With Ci3” April 8

cookies

The next “Cookies and Conversation” will take place Tuesday, April 8 from noon-1 p.m. in the Living Room space of the Institute of Politics (5707 S. Woodlawn Ave., on The University of Chicago campus).

The discussion of the April “Cookies and Conversation” will revolve around emergency contraception, on a local, national and international level.

Held on the first Tuesday of every month, “Cookies and Conversation with Ci3” is a brown-bag informal discussion, about sexual and reproductive health issues in the news and how they intersect with research on campus. The event is moderated by Ci3 staff and consultants, and is open to students.

For questions, please contact Ci3/Section Policy Coordinator Lee Hasselbacher at lhasselbacher@babies.bsd.uchicago.edu.

Thank You for a Great Year – A Message from Section Chief Dr. Melissa Gilliam

Dear Friends,

As 2013 draws to a close, I want to share my sincere appreciation for your support of the Section of Family Planning & Contraceptive Research at The University of Chicago. We want to share a few of the highlights of our work this year in clinical care, research, education and policy which include:

  • Continued growth of our Ryan Training Center, in which we meet more and more women’s needs for abortion and contraception while training tomorrow’s providers.
  • Selection as one of the sites for the National Institutes of Health’s Contraceptive Clinical Trial Network, through which we will partner with other institutions to study new methods of contraception. We were the only new CCTN site selected to participate in a current study exploring the use of ulipristal acetate, currently used for emergency contraception, for daily contraceptive use.
  • Presentation of nine abstracts at the North American Forum on Family Planning at which our senior fellow, Dr. Elisabeth Woodhams, won the Young Investigator’s Award.
  • A new toolkit for healthcare providers, based on lessons learned from our quality improvement research, for providing long acting methods of contraception such as the intrauterine device and implant, primed for national dissemination.
  • A novel approach to supporting women at the time of abortion services: the full spectrum doula. We studied doula support in a randomized controlled trial with surprising findings.
  • Development of a new approach to contraceptive counseling that places patients at the center of care.
  • Continued commitment to training the next generation of providers; two of the Department of Obstetrics and Gynecology’s graduating residents will train to be experts in family planning.
  • An expanded communications program, including an increased social media presence and a relaunch of the Section blog.
  • New policy briefs on topics such as over-the-counter emergency contraception, crisis pregnancy centers and a recently enforced Illinois law requiring parental notification when a young woman under 18 seeks abortion.

I greatly appreciate your continued interest in our work, as well as your commitment to sexual and reproductive health for women and urban youth of color in Chicago. I trust you share my enthusiasm about the work we are doing to advance sexual and reproductive health and that you will continue to follow our progress into 2014. Your ongoing support makes our work possible.

Sincerely,

Melissa Gilliam, MD, MPH

Chief, Section of Family Planning and Contraceptive Research

mgilliam@babies.bsd.uchicago.edu

Please consider making a tax-deductible gift to the Section today, with the knowledge that it will make a real and lasting impact on the future of family planning and contraceptive research. (Please specify “Section of Family Planning” in the special instructions at the bottom of the form.)

“Beyond Safe and Legal” – Lack of Access to Abortion as a Form of Gendered Violence

For Day 13 of the 16 Days of Activism, guest blogger Claire McKinney writes about abortion restrictions as gendered violence.

The past two years have been witness to a prodigious amount of new and pernicious abortion restrictions across the United States. According to the Guttmacher Institute, over 162 restrictions have been enacted over the past two and a half years. Many of these restrictions have taken the form of Targeted Regulation of Abortion Providers, or TRAP laws. These laws operate under the guise of making abortions safer for women by creating more stringent requirements for abortion providers, including upgrading facilities to the level of ambulatory surgical centers, requiring doctors who perform abortions to have hospital privileges, and by prohibiting telemedicine, or the provision of medical services over the internet, of use for many rural residents. The regulations have shuttered dozens of clinics across the United States, eliminating access to abortion for countless women, especially poor women in non-urban settings.

This past summer, the Texas legislature’s attempt to pass several of these restrictions in a single bill reached national attention when Wendy Davis, a representative from Fort Worth, filibustered the bill in the closing days of a special session which had been called for the express purpose of passing incredibly restrictive abortion laws that would close the doors of all but five of Texas’ abortion clinics, forcing some women in rural areas to drive anywhere up to 500 miles to reach a provider. Because the filibuster rules of the Texas legislature require that all speaking must be germane to the bill in question, all 10 hours of Davis’ filibuster worked as justifications to reject the abortion restrictions being proposed.

Wendy Davis

Wendy Davis. (Image: huffingtonpost.com)

The testimony Davis introduced, from members of various medical communities as well as from Texas constituents who were barred from testifying during the public hearings on the bills, displayed the full range of justifications for having full access to abortion providers. From a women’s health perspective, what is troubling about these new restrictions is the co-option of the language of women’s health to justify new restrictions. Opponents of abortion have learned to speak that language of science and women’s health without any concern for the validity of their claims. They claim that these laws are necessary to guarantee the safety of abortion, readily ignoring that abortion is safer than childbirth in terms of complications and risk of mortality. When those who object to new restrictions demand evidence for the need for hospital privileges or clinic standards that are only necessary for complicated surgeries demand to see evidence to support these restrictions, the only response is silence. And yet the bad faith co-option of women’s health continues to ensure that women will be refused the care that is medically necessary and socially desirable.

Concerns for women’s health, for women’s citizenship status, and for unjustified interference in medical practice repeatedly echoed through many parts of the testimony. What is striking that often is not present in thinking through the need for access to abortion is how lack of access contributes to gendered violence and is itself a form of economic violence.

In 2012, Karuna Chibber of the Bixby Center for Global Reproductive Health at the University of California San Francisco found that women who were denied abortions were significantly more likely to experience intimate partner violence than women who had safely procured an abortion. It would be easy to speculate how coerced parenthood places women into vulnerable positions in relation to partners such that they could not leave such partnerships, even if they turn violent. Chibber’s work provides a new way of understanding access to abortion to be an issue not only of a choice of one’s life goals but also a crucial resource for women to avoid situations of intimate partner violence. The right to abortion is also the right to be free from violence.

Roe v. Wade anniversary

Image: salon.com

The economic violence associated with lack of access to abortion is more well established and has been a thread of concern for establishing a right to access to abortion since the movements of the 1960s. Many women who seek abortions do so because they know an additional child will place an unsustainable economic strain on themselves and their family. Women lose opportunities such as the time and resources to attend school and to advance or even hold employment when they cannot afford childcare, ensuring that a cycle of poverty will either begin or persist for these women and their families. Furthermore, women in poverty are those who are mostly likely to lose access to abortion providers by the increased restrictions on abortion. Women with financial needs can travel long distances with relative ease, while these restrictions work to create an economic underclass, whose rights are less than those of the wealthy. The differential health results are themselves a form of violence against women that demands that access to abortion remains part of the activist agenda for women’s empowerment.

Davis’ filibuster delayed the passage of the abortion restrictions in Texas, but only by a couple of weeks. Since their passage, they have been held as constitutional by the Texas Court of Appeals and the Supreme Court has refused to hear the constitutional challenge against such laws. Relying on legislative and judicial forums to protect access to abortion has proven to be less than effective. Instead, protecting and expanding access to abortion requires organizations and individuals to articulate demands not only in the language of health which has become too susceptible to cooption, but also in the language of women’s citizenship and right to be free from violence.

Claire McKinney is a PhD candidate in Political Science at The University of Chicago. Her dissertation develops a concept of medicalized citizenship and the centrality of the language of health in the history of and in present day abortion politics.