February 2020

Be Our Valentine

Valentine’s Day is around the corner! Show your love for reproductive health care. We definitely are! On Valentine’s Day, we will share with you some of the reasons why we love doing this work. We’d also like to hear from you!

Here a few ways to show your love for reproductive health care this Valentine’s Day:

 

• Take a selfie and tell us why you having access to reproductive health care is important to you.  Post on Facebook, Twitter, or Instagram and tag us #RHAPpyValentinesDay.
• Shopping for Valentine’s Day? Select us as your charity of choice on AmazonSmile and they’ll donate on your behalf.
• Show us some lovin’ by supporting this work.

 

June v. Russo: Join the rally at the Supreme Court on March 4!

Three years ago, in Whole Woman’s Health v. Hellerstedt, the Supreme Court of the United States ruled that provisions in Texas House Bill 2 posed an undue burden on people seeking abortion care in Texas. HB2, which included a law requiring any clinician performing abortion care to have admitting privileges at a hospital within 30 miles of the clinic was deemed unconstitutional. Despite this ruling, SCOTUS will once again hear an admitting privileges case on March 4, 2020. June Medical Services, LLG v. Russo, comes out of Louisiana and is identical to HB2. With the retirement of Justice Anthony Kennedy (the decisive fifth vote in Whole Woman’s Health) and the appointment of  Justice Brett Kavanaugh, this case has the potential to profoundly affect the future of abortion access in the United States.

The Supreme Court will also consider whether clinicians, providers, and abortion clinics have third-party standing – the right to serve as plaintiffs and fight for their patients in court. This issue is critical because nearly all abortion cases today are brought forth by medical providers; without third-party standing, only patients who are pregnant at the time would be allowed to be plaintiffs in any legal action challenging restrictive laws. This would make it even more difficult to challenge the unjust laws that deny people their fundamental right to an abortion.

Should SCOTUS uphold Louisiana’s admitting privilege requirement,  all but one clinic in the state would close, denying abortion access to nearly 10 million people of reproductive age. Anti-abortion groups and politicians could be emboldened to pass even more restrictive and medically unnecessary laws, essentially cutting away at our constitutional right to abortion care.

Thanks to the advocacy of many of our Network members, the American Academy of Family Physicians joined other professional medical associations like the American Medical Association and The American College of Obstetricians and Gynecologists in opposing this law. Check out the amicus briefs here.

We know that the admitting privileges law is just one of many Targeted Regulations of Abortion Providers (TRAP) laws that are designed to decimate access to abortion care and prevent clinicians from providing compassionate, quality abortion care. We also know that laws like the one in Louisiana disproportionately affect rural communities, low-income patients, and communities of color. That’s why we are joining forces with the Center for Reproductive Rights and other reproductive health, rights, and justice organizations to rally in DC on the day of oral arguments.

Abortion isn’t a right if you can’t access it. Join the rally on the steps of the Supreme Court on Wednesday, March 4^th, the day of oral arguments. The rally will begin at 8am. Let us know if you’ll be there!

 

The Miscarriage Care Initiative Spreads to St. Louis

The Miscarriage Care Initiative (MCI) expands access to evidence-based, patient-centered early pregnancy loss (also known as miscarriage) care in primary care settings.  Our vision is to support family physicians and health care organizations to integrate all three forms of early pregnancy loss management – expectant, medication, and manual vacuum aspiration (MVA) management – into their clinical practice.

RHAP worked with Affinia Healthcare in St. Louis, Missouri on the Miscarriage Care Initiative starting in the summer of 2018.  Drs. Baum, Tepe, and Pachalla at Affinia Healthcare describe how participating in this program impacted their work.

“Affinia Healthcare is a large FQHC in St. Louis, Missouri that serves 43,000 patients per year in an integrated model of medical, behavioral, and dental health. Within primary medical care, we have a large women’s health department that performs around 1600 positive pregnancy tests per year and delivers approximately 800 babies. Early pregnancy loss is a very common occurrence, but stigma prevents many patients from talking about this experience. Without any support, it can be traumatizing and emotionally exhausting. Affinia Healthcare is a trauma-informed care organization with a mission to provide high quality health care. Many patients are comfortable in our office with the team that normally cares for them. They appreciate being able to access services in this familiar setting and avoiding the hospital experience and cost. Offering the full spectrum of early pregnancy loss care in a safe and comfortable environment is an example of how the health care we provide aligns with our trauma-informed and patient-centered ideals.

Through RHAP’s Miscarriage Care Initiative, we were able to bring together a diverse team from our staff to integrate all the aspects of full spectrum early pregnancy loss care. Our team was co-led by an OB/GYN and a Family Medicine physician.  Our organization’s chief medical officer (an OB/GYN) led administrative logistics and the entire team collaboratedwith  nursing staff, pharmacists, and administrative staff. RHAP provided support in the form of sharing draft materials, ensuring deadlines, sharing best practices and articles, and providing technical assistance. Together, we’ve achieved every aspect of the program goals, including integrating medication management using mifepristone and misoprostol as well as aspiration procedures.

Within just one year of starting the MCI, we have completed approximately 10 early pregnancy loss procedures. The current polarized climate often prevents patients from accessing the reproductive health care they need, which is why we’ve worked so hard to establish high quality standard of care therapies. This has made the difference for patients like KW. KW, a long-time patient with Affinia, was thrilled when she found out she was pregnant. She scheduled her ultrasound and prenatal care visits with our team. Before her first appointment she started spotting and went to the hospital where an ultrasound showed signs of an early pregnancy loss. We brought her back to our office one week later and confirmed that she was no longer pregnant. Our team used a patient-centered and trauma informed approach to counsel KW on her options, and she decided to try watching and waiting. When this didn’t work, she was able to come to our office where she had been receiving care and get an aspiration procedure. Through participating in the MCI, we were able to develop the systems, policies, and supports that KW required to receive sensitive and high quality care from clinicians she already knows and trusts. She didn’t have to go to a different office, deal with unfamiliar clinicians, or get saddled with the large bills that often come with going to the hospital. We also have the pleasure of continuing to provide care to KW, who is again pregnant, and now with a viable pregnancy. KW, and many patients like her, are why we were so thrilled to work with RHAP and participate in the Miscarriage Care Initiative. 

 

Reflections on Roe

On January 22, we co-hosted an event to celebrate the 47^thanniversary of Roe v. Wade Supreme Court decision with our allied organization RHEDI (Reproductive Health Education in Family Medicine). More than 80 people joined us for a discussion exploring the reality of abortion access today. We heard from the Center for Reproductive Rights’ Lourdes Rivera, Liza Fuentes from the Guttmacher Institute, Network Member Dr. Hinchcliffe, and Reproductive Justice Educator and Advocate Adjoa Tetteh. They offered solutions and actions to overcome the ongoing attacks on abortion.

We are excited to continue working in 2020 to strengthen abortion access all over the country. Everyone should be able to live, work, and make decisions about our health and our future. It’s time to lift the bans that deny abortion coverage. Here’s how you can get more involved: 

• Rally at the U.S. Supreme Court for abortion access on Wednesday, March 4, 2020 from 8:00am – 11:30am. RSVP today: http://bit.ly/SCOTUS_rally 
• Support a local abortion fund. 
• Offer your support and resources to your friends, family, and network in low access states. Click here to see which states are at risk of losing abortion access and click here to stay up to date on state policy trends. 
• Support the EACH Woman Act & Women’s Health Protection Act.
• Check out RHEDI’s resources for abortion and contraception education. 
• Help us train, mobilize, and support primary care clinicians to protect access to abortion, contraception, and miscarriage care.