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Visit our new online store!

May 15, 2013

store_windowThe Reproductive Health Access Project publishes a variety of patient education materials and clinical tools. Now, you can purchase these materials at our new online store! Visit it today at store.reproductiveaccess.org

We believe in promoting evidence-based, patient centered medicine. All of our patient education materials are medically accurate, drawn from the latest clinical information. We field test our patient education sheets to make sure that they are easy to read and use. Colorful and beautifully designed, our patient education sheets are perfect for use at health centers, doctors offices, and school based clinics.

Our new online store allows for easy browsing of our materials. Many of our fact sheets are available in multiple languages, including Chinese, Creole, English, Portuguese, and Spanish. We strive to be eco-friendly, so all of our materials are printed using soy based ink and can be printed on regular or recycled paper. Have questions about an item or want to order in bulk? Email us at store@reproductiveaccess.org.

All the proceeds from our online store help support our mission of integrating contraception and abortion into primary care. We’d love to hear your feedback so check out our new store today!

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Diminishing shame

April 16, 2013

Hand ReachingI work once a week at a high volume abortion site.  When I’m there I often don’t have the chance to have much of an interaction with the patients in the minute or so that I see them before the anesthesia takes effect.  But the other day, I had a quick conversation that really stuck with me.   The patient was a woman in her mid thirties, though she looked even older.  She seemed quite distraught as she lay there getting her IV, so I sat down next to her.  ”I’m feeling quite down on me-self” she said quickly, with a bit of a brogue.  ”I know how that is”, I said to her, “I’ve been there, too.”  ”You have?”  She looked at me with great surprise… “but this is my second!” she replied, starting to tear up.  ”I’ve had two, too.”  I said.  She looked at me even wider eyes, confused about how this could be true.   “Shit happens.”  I said.  (I don’t usually use curse words with patients, especially not one I don’t know, but it just came out!)  She smiled.  ”Don’t it, though?!” she said, as she squeezed my hand, nodding peacefully as she went under.

I don’t know why I still struggle a little with being open about my abortions. I guess I just have internalized a tiny bit of that shame, myself.  I froze for a moment when I found out Physicians for Reproductive Health wanted me to talk about my abortions at their public forum event around Roe v. Wade.  I had to have a good talk with myself to get past that!  And then it was fine.  It is important for younger women to know what those pre-Roe v Wade abortions were like, even the ones that were semi-legal like mine—because they were no picnic.  Still, it’s one thing telling colleagues and movement allies about your abortion and another thing sharing it with patients.  It’s a bit delicate, picking when it’s appropriate and when it might diminish what a patient is trying to share about herself, so I tread lightly.  I have to say, every time I have done it, it has been a good thing.  It breaks down myths such as “other women have it together, I’m messed up,” a central theme I find.  Or, “I won’t be OK after this” or “doctors don’t really approve of abortion.”

I’m trying harder to be more out there about my abortions.  I like to think that the cup of shame in me gets a bit smaller each time I tell someone and the part of me that belongs to the community of women who care deeply about children getting raised under the best of circumstances grows bigger each time.  Because that’s what it’s really all about: growing healthy families.

 

 

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Notes from a Doula – Caring for Men

April 2, 2013

As part of my work with the Reproductive Health Access Project, I am a doula for women undergoing reproductive health procedures like colposcopies, IUD or implant insertions or manual vacuum aspiration.  A doula, in essence, is someone who provides emotional support.  At first,  I was not sure how I was going to be able to do that.  What do I say or do in this in this type of situation? How was I going to help? Quickly, I realized my role.  To put it simply, removing all labels and fancy language, I am a friend. And this concept was not foreign to me all. It is skill we have all been developing and honing since kindergarten or for those of us with older sibling the moment we were brought home from the hospital.  We meet someone. We introduce ourselves. We find common ground.

Over the past two months, I have been able to support many women.  I have met mothers, lawyers, nurses, authors, students, and teenagers. The list goes on and on.  All of whom I felt comfortable with as I fulfilled my role as their friend.

A few months after joining RHAP I started to feel relatively settled.  I knew what to expect, how to read situations and act accordingly.  Some women like to be distracted by conversation. They immediately open up and the discussion flows freely as we talk about work, family, travel, fashion, food, and often the one thing we know for sure to have in common, living in New York City. Other times I walk into the room and can sense that a woman just wants to sit in silence.  I smile and reiterate that I am there purely to support her need.  I ask if she would like to talk and if it looks like she needs it, I offer my hand to squeeze.  In every procedure I find myself breathing in unison with the woman I am supporting, helping to steady her breath and relax.

What to do often comes naturally.  My initial nerves dissipated and were replaced by an eagerness to be present in as many procedures as possible, knowing the difference it makes to each woman.  At this point I am sure you have noticed a common thread throughout these experiences. Women. Women supporting women.  So, recently when one of the doctors I work with asked me if I would doula for a vasectomy, I felt hesitant to say the least. In my head that was a totally different ball game.  What should I say to a man in that situation? Is he going to be okay that I am there?  Would it be awkward for him? The patient was a young man, just a few years older than me. I don’t carry the title of doctor and my title of friend all of a sudden did not seem official enough.  All these thoughts and emotions were clearly painted across my face because the doctor laughed and told me I had time to think.

When she came back I was about to let her know that I was going to sit this one out but she said, “Come on it is the same thing. Give it a try!”

I walked into the room and introduced myself.  It was clear that both the patient and I were both a little nervous, this being a first for us both. I am fairly certain he had never had a doula before. So, I started to make small talk.  Slowly small talked turned into a casual conversation about his kids, New York, and even why he was getting the vasectomy.  He was chatting away and fully engaged with everyone in the room, from me to the doctor and the resident. I could tell that having me there to get the conversation going put him at ease.  I am not a doctor. I was just there to talk and open up that line of communication. By the end of the session he was sitting up watching the whole procedure!

Afterwards, I was glad I didn’t shy away from the experience. Working in women’s health, it is easy to become very female focused.  Taking care of a person’s reproductive health can be scary at times, especially undergoing a procedure alone. That goes for men and women.  We all get nervous. And friendship is not gender specific.

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New Educational Resources on Natural Family Planning and Sterilization

March 20, 2013

nfp-1sterilizationWe’ve just released two new birth control fact sheets covering  Natural Family Planning and Permanent Birth Control (Sterilization).

The Natural Family Planning (NFP) fact sheet lays out seven common methods of natural family planning, and compares them by efficacy. The sheet explains how each NFP method works and lists common pros and cons.

The Permanent Birth Control (Sterilization) fact sheet describes the different sterilization options for men and women. The sheet addresses how the sterilization procedures work, recovery time, efficacy, and average cost per method.

These were tricky to write. Not because we couldn’t get the information, but because the information was so technical.  We strive to  make all  our patient education materials easy to read and understand.   Our goal is to make them readable at a 6th grade reading level.  That means short sentences and few multi-syllabic words (like multi-syllabic!).  Imagine the challenge to explain the Sympto-Thermal Method of natural family planning or describe tubal ligation or vasectomy!  We worked hard to make the language clear and easy to understand and then field tested both fact sheets with clinicians and patients.

Like all our materials, these new fact sheets are available in English and Spanish and can be download for free from our website.

Let us know what you think and enjoy!

 

 

 

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Five Years Later: assessing the impact of reproductive health clinical training and post-graduate support services

March 5, 2013

5_years_laterWe at RHAP have always known that just because clinicians are trained in abortion care doesn’t mean they will provide abortion care.  Whether or not clinicians can provide this care rests on many factors including:  where the individual practices are located, the support of their colleagues, the ability to access the right equipment and supplies, funding restrictions, and state laws.

In 2007 RHAP launched the Family Medicine Reproductive Health Network to help family physicians trained in abortion care actually provide abortion care. Whatever obstacle they encountered, we try to figure out a way around it to increase the number of family physicians providing abortion care and to expand abortion access to women in need.

One of the first things we did to build the Network was to systematically connect with every family physician who received abortion training.   Working together with the small, but growing, number of residency programs that offer abortion training to family medicine residents and with the reproductive health centers that provide this training across the country, we send a survey every spring to nearly every family medicine resident trained in abortion care. The residents tell us about their training and future plans, and we, in turn, share our tools and resources with them and link them to Network mentors who help them as they start their clinical practices.   Those residents interested in providing abortion care as part of their future practice join our Network.

Since 2007 we have added more than 325 newly trained family physicians to our Network.

Several years after launching the Network, we wanted to know whether our approach was working.  Have our mentoring and support services actually helped clinicians become abortion providers?

To answer that question, RHAP developed another survey in which we ask our Network members, five years after graduation, how their residency training and our efforts have affected the care they provide.  The 2007 family physician graduates were surveyed in October 2012, and although the number of physicians surveyed was fairly small, we feel heartened and hopeful that the help they received has led to their growing role in providing comprehensive reproductive health care and that our work is making a difference.

Here are some highlights from the first cohort of family physicians responding to our 5-year follow-up survey:

Most of the family physicians are providing community-based primary care, and most work in community health centers.

A fifth (21%) of the physicians who responded to our survey are providing abortion care as part of their regular clinical practice.  Another 15%, unable to provide abortion care in their primary clinical practice, work part-time in secondary jobs where they provide abortion care.  Overall, more than one-third of the physicians provide abortion care.

All of the physicians who provide abortion as part of their primary clinical practice work in federally funded community health centers—a challenge to our long-held view that working at a federally funded community health center would pose a huge obstacle to providing abortion care.

70% of the physicians are treating early pregnancy loss.  This means that they are using their abortion skills (manual vacuum aspiration, ultrasound, and medication management) to manage miscarriage—even if they aren’t able to provide abortion care.

100% of the family physicians are offering a wide range of contraceptive options, including IUDs, at their primary clinical sites and 100% offer patient-centered options counseling.

86% are involved in clinical training.  This means that their reproductive health clinical training is being passed on to the next generation of clinicians.

80% of the respondents indicated that they had received help from RHAP and the Family Medicine Reproductive Health Network.  Just about all of them had accessed our website, use our patient education materials and clinical protocols, and subscribe to the Contraceptive Pearls.  30% reported receiving individualized technical assistance from us.

This is just the beginning.  Over the next few years, as we reach out to more of our Network members, we’ll have a better sense of how abortion training and our efforts are changing the landscape of reproductive health care in this country.  In the meantime, we’re thrilled that our efforts to bring more training and opportunities to committed physicians are starting to make a difference in women’s lives.

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What’s in a name (or a tagline)?

January 30, 2013

A couple of years ago, when the Reproductive Health Access Project celebrated its 5th anniversary, we created a special tagline to mark the occasion:  making choices real.  I loved it.  I still love it.   It telegraphs the fact that, even though abortion and contraception are legal, many women still face tremendous barriers in accessing this care.  The “choice” isn’t yet real for everyone one.

But, the word “choice” has fallen out of favor.  Experts suggest using “decision” instead.  Choices are seen as too flip.  Decisions are thoughtful.   But, “making decisions real” just doesn’t work.  It doesn’t convey our mission and work – integrating contraception and abortion into primary care–in the same way.

So, we took into account the experts’ advice and set upon coming up with a few energizing words that would motivate our supporters, convey our passion for our work, and explain our complex mission.

We identified the key points about ourselves we wanted to convey.  We pinpointed our target audience. We researched taglines of sister organizations.  We collected a list of taglines we love for inspiration.    We discussed, argued, and grappled with using the word “abortion.”  We vowed not to use jargon or be too clinical.   We brainstormed, brainstormed and brainstormed.  What did we come up with?  Our five tagline finalists were:

Contraception and abortion access for all
Changing the Culture.  Caring for women.
Inspire.  Educate.  Advocate.
Breaking down barriers.
Because it shouldn’t be so difficult.

In October we presented our shortlist to our staff and board, hoping finally to pick one.   Here were some of the comments.  See if you can guess which tagline each comment applies to.

it has a ‘to the barricades’ feel….it could apply to any organization….it’s not exactly what we do….it’s too negative….what about men, don’t you care about men?

In the end, we didn’t come to agreement on any of the proposed tag lines and instead settled on this:  integrating contraception and abortion into primary care.  It’s not pithy or catchy, but it gets across exactly what we do and includes the word abortion.  I can live with that.

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2013 is going to be a great year!

January 16, 2013

Thank you!

We met our year end fundraising match, and then some!  Supporters like you gave more to the Reproductive Health Access Project in 2012 than ever before.  This means we’ll be able to do even more in 2013.  We have lots of plans in store:  expanding our clinical training opportunities, creating new clinical tools and resources, working on the ground in places like Arkansas, Montana, Rhode Island and Texas.

This month marks the 40th anniversary of the Roe v Wade Supreme Court decision.  While we’ve made great strides in improving abortion care and the health of women since 1973, today more than half of all women in the United States live in a state that restricts access to abortion is some way.

We are proud that the work we do is pro-active.  By working directly with clinicians who care for the most underserved populations the Reproductive Health Access Project expands access to contraception and abortion in the most restricted areas.  Clinician by clinician, state by state, we are quietly ensuring that the legacy of Roe continues to be meaningful in our country.

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Happy holidays from all of us

December 21, 2012

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Helping a physician become an abortion provider

December 12, 2012

It’s often difficult for doctors who received abortion training while in residency to integrate the service once they are in practice.  They face many barriers including resistant staff members, malpractice costs, and the need for additional clinical training. An experienced mentor can be helpful in developing strategies for overcoming these barriers.  Each spring the Reproductive Health Access Project reaches out to graduating family medicine residents trained in abortion care to offer them support and to pair them with seasoned practitioners in their area to serve as mentors.

Last year we identified two well-trained, highly motivated physicians in Arkansas—a state with only one abortion provider–who needed mentors.  But, we had no local mentors available.  RHAP is a “can do” organization, so we analyzed the problem from all angles and came up with a solution.  What if we became the mentor?  What if we worked intensively with these clinicians to help them work through the barriers to providing abortion in a rural, underserved area? Together with ANSIRH (Advancing New Standards in Reproductive Health) we created the GAPS (Graduate Abortion Provider) Fellowship to do just that.  Last year, one of the Arkansas clinicians became our first GAPS Fellow.

Through the GAPS Fellowship our Arkansas clinician was able to attend the annual National Abortion Federation meeting so they could become an active part of the national abortion provider community.  The GAPS Fellow also received funding to help underwrite some of the start-up costs of providing abortion care (such as $1,000 towards the additional malpractice coverage they had to get). The GAPS Fellow also got lots of one-on-one technical support from me, RHAP’s national organizer, and clinical support from RHAP’s medical director, Dr. Linda Prine.   In September 2012, our GAPS Fellow started offering medication abortion in their rural family medicine practice.

It’s hard to say what element of the GAPS Fellowship had the biggest impact on the outcome, but we can’t underestimate the value of the intensive technical assistance.  I dedicated more than 100 hours to working through the issues necessary to set up abortion services in Arkansas.  What exactly did I do?  Here’s a short list:

-Reached out to referral sources throughout the state to help the physician build their practice.
-Reached out to potential allies who would support the physician should they ever face harassment.
-Researched state restrictions on abortion care.
-Created clinical systems and procedures to ensure compliance with state abortion regulations such as the 24-hour waiting period and mandatory parental consent.
-Identified resources for the additional malpractice required for a family physician to provide abortion care.
-Identified resources for low cost IUDs.
-Created medical equipment and supply lists.
-Identified a back-up physician to handle complications.
-Developed a plan for providing adolescents confidential reproductive health care (including resources for minors needing a judicial bypass).
-Strategized how to let patients know that the practice offered comprehensive reproductive healthcare.
-Identified rape crisis centers and other local resources for patients.

I just started working with our 2nd GAPS Fellow, the other clinician in Arkansas who needed a mentor and I can’t wait to replicate our success. If you have suggestions about a future GAPS Fellow, send us suggestions or apply today!

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IUD Evangelism

December 11, 2012

Apparently IUD users love their IUD so much they can’t help themselves from spreading the word about how great a contraceptive option it is.  New York Magazine is calling this phenomena “IUD Evangelism.”

Why is getting an IUD an almost spiritual experience?   “..learning about the IUD is like discovering that some benevolent God has been listening to your specific complaints about being a woman and will deal with them one at a time. Are you tired of refilling birth control prescriptions? Can’t remember where you left your pills? With the IUD, you’re baby-proof for up to ten years. (Doctors call it the “set it and forget it” method, like the rotisserie ovens sold on TV.) Do the hormones in birth control pills make you cry, as one IUD evangelist put it, “at the tiny hand in the March of Dimes commercial?” The copper IUD is hormone-free. Don’t trust him to pull out punctually? Sick of searching for the elusive Sponge? The IUD is as effective as sterilization until you take it out. (Although, as with tubal ligation, things happen.)”

Linda Prine, RHAP’s medical director, provides clinical background on why IUDs today are safer than previously available versions.  “The biggest upgrade to the IUD since the Dalkon Shield is in the one- to two-inch string threaded through the cervix to hang down into the vagina to ease removal, said Dr. Linda Prine, the medical director of Reproductive Health Access Project who trains family doctors in IUD insertion. In the past, the strings were made from a multifilament that “wicked” bacteria into the uterus. Now, Dr. Prine explained, the strings are made of monofilament that doesn’t facilitate the transfer of bacteria. The hormonal IUD, meanwhile, causes the body to produce — brace yourself — a cervical mucus that’s like a “plug” against infections.”

Read the entire article here.  Want to learn more about the IUD?  Check out RHAP’s clinical resources and patient education materials.  Or, email us!

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