According to a report by the Commonwealth Fund, women of reproductive age in the United States have the highest rates of preventable deaths when compared to ten other high income countries and a maternal death rate three times higher than any other country in the report. Rosemary Morgan, an associate scientist at John Hopkins University says, “The fact that the U.S. ranks last across a number of indicators should be a wake-up call for everyone. This data reflects the historical neglect of women’s health within the United States, which is a gender bias that continues to persist.” Munira Gunja, senior researcher for the Commonwealth Fund’s International Program in Health Policy and Practice Innovation adds, “U.S. women are sicker, more stressed, and die younger compared to women in other countries.”
We may not have learned anything new about gender disparities in healthcare during the pandemic, but the existing inequalities were highlighted in a sobering way.
Women’s health was disproportionately impacted by the pandemic — they made up the majority of high contact front line workers, performed the majority of domestic labor, were most affected by intimate partner violence, were most likely to have gone without healthcare during the pandemic, and were most likely to be unemployed or underemployed during the pandemic, among other things. Additonaly, the pandemic compounded existing inequities in healthcare by disproportionately affecting Hispanic and Black women, queer women, and women with fewer financial resources. There was an increase in stillbirth, maternal death, maternal depression, women canceling and delaying healthcare appointments, unintended pregnancies, and unsafe abortions, and a decrease in access to birth control and reproductive health services.
The women impacted by the careless disregard for women’s health and bodily autonomy in our country are the women you know in this community. They are your neighbors, your sisters, your friends. And though a woman should not have to be assigned relational proximity in order to gain enough value to be treated with dignity and equity, it is important that we elevate voices of those assigned female at birth and that we LISTEN —
Listen to the woman being denied a tubal ligation because her future husband may want children, the woman without funds to drive across country for a legal abortion, the woman whose chest pains are being dismissed as anxiety, the woman who feels like something isn’t quite right after giving birth, the woman who can’t afford birth control….
Below, six women in our community generously shared their experiences with healthcare.
On April 5, 2021, I had a modified radical hysterectomy, for cervical cancer. I have friends who have been fighting with their doctors and insurance companies to have hysterectomies for health and reproductive reasons. But the majority have had to jump through hoops to justify why they want the procedure. Some even need their partner’s consent. Consent and justifications about what they do with their own bodies. So, while having my own hysterectomy made me partly sad for any future children I may have had, watching my friends struggle to have the same right really put things in perspective for me. I have two children, but it was my choice. Everyone should be able to choose what happens with their bodies and their futures.
—Anonymous
My entire life, I knew I did not want children. I came from a home of alcoholism, abuse, and mental illness. These were things I had no desire to pass on to another human and in general did not have any desire for kids. Pregnancy has always been something that just… freaks me out. Because of this, I have always been on birth control.
At 23 years old, I started having major issues with my menstrual cycle. I had bleeding every other week for about a year, a constant up and down of PMS, then period fatigue, then PMS again. It was horrendous. At one point, I had my period for 56 days straight. I saw my then OB and asked her what we could do, [saying] that I was absolutely miserable and just wanted the birth control out of me. She said we’d give it “the ol’ college try” and just gave me estrogen pills to stop the bleeding. I decided then that I would never see her again. None of my concerns were taken into account.
Clearly, something was wrong. I decided I wanted to get a tubal [ligation]. I wanted no more birth control, and to have a permanent solution to whatever was going on. I went to my primary doctor with a bullet point list of all the reasons I was okay with never having kids. I had a notebook filled with all the issues I’d been dealing with for over a year, and a resolute decision to not leave there until I was granted a real talk about my health. She asked the normal questions they ask almost every woman like, “You’re not married; what does your partner think of this?” “Have you talked to your fiancée about what he thinks you should do?” and “what if you meet another guy someday who wants kids? What will you do then?”
I gave very curt answers about how I did not care about a hypothetical man’s opinion; this was my body, and I knew what I wanted. She signed off on a consult for a tubal. I then went through the channels to get it approved, which was just more of the same questions. I was pretty awestruck that I was old enough to decide I wanted kids, but apparently not old enough to decide I DIDN’T want kids. I stuck to it, and a month or so later at 24 years old, I had my tubal.
When they removed my fallopian tubes, they found that they were filled to the brim with paratubal cysts. They checked them for cancer and luckily, they were benign, but it made sense why I’d had so many issues for so long. I am so grateful to have gotten the surgery I wanted and needed, to have a permanent solution to my never-ending menstrual problems, and have no more birth control in my system causing hormonal and mental anguish. It was and is one of the best decisions I ever made, and I have no regrets about my decision to take care of my own body.
—Bailey Jo Still
At the age of 24, I became pregnant while using birth control. I had just started on the path to recovery from substance abuse and had started college. My son who had been taken from me had just came back home to live with me. He was six years old.
If it had not been for abortion rights, I am fairly certain I would have returned to using drugs and alcohol in an effort to miscarry the child. Fortunately, I could secure a safe abortion and didn't have to resort to drastic methods. My son got to keep his mom, and I got to keep my recovery.
—Alicia E Lopez
On Monday, February 21, 2022, I was diagnosed with stage 3a breast cancer. Ten days prior, I had discovered a mass in my right breast and scans later showed it had spread to my lymph nodes in my armpit. At 29 year old, I was given the scariest news of my life, but I had no idea how incredibly complex a breast cancer diagnosis this young would be.
I thought maybe I would receive treatment and move forward with my life, but the journey has come with hard decisions as it relates to my body, my mental health, and my fertility. Some of those decisions have been made for me, some have been left to fate, and some I have tried my best to make in hopes that the outcome would mean I would survive and enter remission.
A day after my initial diagnosis, I met with my first doctor who would be the lead on my double mastectomy. Most of the appointment was spent explaining what my diagnosis was and what breast cancer is, but casually at the end I was thrown a curveball: I am young, chemo will destroy my ability to have children, and I need to think about preserving my fertility with egg preservation.
Um, what? What do you mean chemotherapy will destroy my ovaries? During the most stressful event of my life, I was being asked to consider spending thousands and thousands of dollars to preserve my eggs and make intense decisions about my reproductive health in a matter of a couple of weeks. There was so much pressure to make a decision about my body when I didn’t even feel confident at that point I was even going to survive, myself.
I felt immense pressure as a young woman because the expectation was that five years from now, I would want kids. But I honestly had no idea if my partner and I did. I just was hoping I would get to live at this point.
Fast forward to two weeks later when I met with my oncologist for the first time. I quickly learned that egg preservation was not in the cards for me, even if I wanted it. My breast cancer is estrogen positive, meaning estrogen essentially feeds my tumors. If I chose egg retrieval, I would not only be delaying life saving treatment, but I would make the cancer worse. I was informed that chemotherapy would not completely obliterate my ovaries and their ability to produce eggs, but it was very likely that becoming pregnant would be challenging for me.
However, I was presented with the option to start a hormone blocker injection during treatment that would shut down my ovaries and I would enter menopause.This treatment is something I had to do after chemotherapy regardless for five years because my type of cancer is hormone positive, but I could start it now in hopes that it could help my body preserve what it could.
In theory, by 35, I could stop the hormone blocker, check my fertility, and be given a small window of time to have children if I want and if I am able. But no matter what, I will have to have a hysterectomy by the time I am 40 because I ended up testing positive for the BRCA1 gene, a gene mutation responsible for breast cancer and ovarian cancer.
But the most important part of that conversation that my oncologist stressed to me was that I cannot and should not get pregnant during treatment. Period. It would result in a pregnancy I would have to terminate. Before the leaked Politico article about Roe v. Wade potentially being overturned, this conversation did not scare me. These are services I have been privileged to have access to my entire sexual history without even a second thought. I knew that in the event something happened and I became pregnant, I could have access to what I needed so that I could survive.
However, Roe v. Wade is in the balance, and this conversation has been critical in the adolescent and young adult (AYA) cancer community. So many women have shared their experiences finding out they were pregnant and have cancer at the same time. Abortion is part of that conversation, as many cannot carry during treatment.
Having access to abortion services is critical in these scenarios because oftentimes there is not even a choice. Abortion is the only option. Is that option easy? No. But it is also a means of survival. And it needs to remain accessible and safe to everyone.
So much of my reproductive health has been decided for me because of my cancer diagnosis. I grieve for that because I don’t get a say in what happens to my body or fertility at this point. The goal is for me to survive and I have to choose that every day. I do choose that. But I believe every woman should have a say in their reproductive care. Roe v. Wade is critical in protecting that.
Nobody should be told what they can and cannot do with their own body. Period.
Women deserve access to safe abortions. The removal of Roe v. Wade doesn’t stop abortion. It stops safe abortions.
—Madison Evangelista
When I was younger and didn't have health insurance, Planned Parenthood was the only place I could go for routine health care, like pap smears. They also provided me with birth control.
I have a condition called Factor 5 Leiden Mutation, which puts me at high risk for blood clots. Because of that, I had to use an IUD for birth control, which isn’t common for women who have never been pregnant — it’s harder to get the device into the cervix of a woman who has never given birth.
I had pretty horrible experiences with non-Planned Parenthood doctors (including one doctor who looked at me in disgust and said, “Oh, that doesn’t hurt!” when I cried out in pain during insertion). I wish all healthcare workers in reproductive care were like the Planned Parenthood ones. I hate that they get such a bad rap... they seriously have so many programs and fundraisers to help the community.
—Sara Quinn
I was on birth control both times I got pregnant. I was in a committed relationship with someone where we were both tested for STDs before we ever had unprotected sex, and I was on the birth control pill. I was 20 years old the first time and was not in the position to raise a baby. I immediately knew I needed to have an abortion, and I did. It wasn’t easy, though! I didn't realize I was pregnant until I was 12 weeks along because I regularly skipped the pills that would give me a period, which was allowed.
I had to attend an appointment first to talk about all of my available options, take a pregnancy test, and get an ultrasound where they made me listen to the fetal heartbeat. Still, I felt confident in my decision. Afterward, I switched to what I was told would be a more reliable form of birth control and got my shots on time.
Almost a year to the day later, I ended up in the emergency room with horrible pelvic pain. Through ultrasound, they found I was about 14 weeks pregnant, but I also had a large blood clot in my uterus, surrounding the fetus.
The doctor gave the chance of carrying to term a probability of about 2%. I was still with the same boyfriend, and we still weren’t ready to be parents. We were young and crazy and enjoying our freedom. But, still, the thought that maybe the pregnancy was ‘meant to be’ nagged at me! What were the odds that I would conceive two years in a row on birth control?! I didn't rush the decision because it was important to me that I make the right one and had an abortion at 16 weeks.
The recovery was horrendous. My mental health suffered. I cried for weeks and the stress of it all ended my relationship. I have three children now and still know I made the right decision, but sometimes I still dream about a baby girl I never met.
— Anonymous
A recent study that surveyed individuals who chose to share their abortion stories publicly found that 60 percent of those individuals were harassed afterwards. However, even those who experienced harassment described having the opportunity to share their experience as empowering. Creating spaces for female identifying folx and those assigned female at birth to talk openly about their sexual and reproductive health experiences is necessary. Listening to these stories is necessary. Taking action to ensure all people have access to medical care is necessary.
Let’s make our community a safe place for womxn.
To act, visit:
http://www.homelessprenatal.org
https://www.plannedparenthood.org
Ashleigh Rogers is a Tri-Cities artist who wears many hats. One of her latest projects involves investigating how COVID-19 has changed our world, and uncovering the community’s vision for the future.
