Nov 06
About
June 2020
Black Lives Matter | Rooting Our Values in Action
The Reproductive Health Access Project condemns anti-Black, state-sanctioned violence and the brutal murders of Breonna Taylor, George Floyd, Tony McDade, Ahmaud Arbery, David McAtee, and of countless other Black folks lost to the system of white supremacy upon which this country was founded.
We stand in solidarity with the Black Lives Matter movement, Black protesters, organizers, and colleagues. As a predominantly white-led organization, honoring their pain, anger, and grief means rooting our solidarity in tangible actions. It means recognizing that this country’s legacy of violence against Black, Indigenous, and People of Color continues both within and outside of the confines of our organization.
This uprising against white supremacy and police brutality is happening within the context of the COVID-19 pandemic, which has magnified and exposed disparities rooted in structural and institutional racism that have long existed in our society.
Our organization operates within a health care system that perpetuates inequities. The reproductive health field, in particular, has long benefitted from the exploitation of People of Color. In fact, many of the modern contraceptives and medical procedures used today are a result of abusive experimentation on enslaved Black women, testing birth control pills on Puerto Rican women, taking and profiting from Henrietta Lacks’ cells without her consent, and countless other violations of Black and Brown bodies. And today, coercive Long-Acting Reversible Contraception practices are still pervasive in Black and low-income communities.
RHAP’s mission is to ensure that everyone can access the reproductive health care they need to be able to live healthy, fulfilling lives. We will not have true reproductive freedom until everyone is able to live safely – free from all forms of violence and oppression. Fighting racial oppression and centering Black voices is paramount to this goal. We also recognize that as individuals – especially those of us who are white-identifying – we have a responsibility to critically examine our own implicit biases and deliberately center the experiences of People of Color in our personal and professional lives.
RHAP affirms our individual and organizational responsibility and commitment to incorporating a racial justice lens into our work, and we acknowledge that we have a long way to go. To that end, we are:
- Reaffirming our values to ensure that they are the foundation of all aspects of our programming and organizational structure.
- Dedicating financial resources to engage in ongoing anti-racism dialogues in order to implement a meaningful anti-racist lens into our work.
- Having, and continuing to have, frank and open conversations about how racism operates within our own organization and the reproductive health and primary care movements at large.
- Reviewing our current strategic plan to make certain that every program deliberately centers the needs and experiences of People of Color, especially Black people.
- Including People of Color at every level of RHAP by intentionally recruiting and cultivating leaders who are People of Color and examining our current processes and systems to address existing barriers.
- Consciously organizing clinicians to use their power to lift up the activism of reproductive justice and Black-led organizations, and advocate for racial justice within medical education, health care delivery systems, and medical associations such as the American Academy of Family Physicians.
Demonstrate solidarity and take action today:
75 Things White People Can Do for Racial Justice
Healing from Internalized Whiteness: An Online Training
Resources for Clinicians and Medical Students
Comprehensive Medical Mentoring Program
Racism in Medicine: Shifting the Power
Tackle White Supremacy at the Workplace
ReproJobs: White Supremacy at the Repro Office
Guide to Discussing Identity, Power, and Privilege
White Supremacy Culture and Antidotes to it
Directory of Community Bail Funds
What Is Telehealth?
Throughout the COVID-19 pandemic, you may have heard that health care centers around the country are increasing their telehealth (or telemedicine) services. As we continue to socially distance to protect one another from this virus, telehealth can be a vital tool for health care systems to ensure that everyone can get reproductive health care safely and when they need it. But what exactly is telehealth?
Telehealth has long been used as a technology to facilitate access to health and medical information, education, and services. This includes utilizing text messages, emails, specialized software, and video-conferencing. Clinicians can use these platforms to exchange health information, provide services to patients, or to obtain recommendations and advice for patient care from other clinicians. While telehealth is all-encompassing, telemedicine specifically refers to interactions involving clinical care –though these terms are often used interchangeably.
Telehealth has been an incredibly important tool for expanding health care access, including specialized care, for rural and otherwise medically underserved communities, helping reduce health disparities for many populations. For example, many low-income women tend to delay or forgo necessary health care due to challenges navigating transportation, childcare, or other logistics. Telehealth can bridge this access gap for many communities.
Telehealth plays an important role in timely, safe access to contraception and abortion care. It facilitates patient-centered counseling, assessing risk factors, and sending birth control prescriptions. The TelAbortion program works in 13 states to provide telehealth medication abortion under a special Food and Drug Administration (FDA) waiver for research. They connect pregnant people seeking abortion to video consultations with certified clinicians, then the abortion pills are mailed directly to patients. However, not all reproductive health services can easily happen through telehealth. For example, some people may want their contraceptive implant or IUD removed (and may not feel comfortable with IUD self-removal). Also, telehealth for medication abortion care is effectively banned in 17 states.
Increasing telehealth visits for reproductive health care and other services can prevent people from congregating in health care centers, protecting patients and health center staff, while allowing those who need in-person care to obtain it safely. Check out our COVID-19 Resource Page, which contains free tools on telehealth to support providing reproductive health care in this new environment.
Pride 2020 and Gender-Affirming Care
Social distancing has redefined the way we approach daily life, work, community, and care. As a society, we are finding new ways to uphold our values, learn, and connect. This year, with New York’s Pride March reformatted to a virtual gathering for the first time in its half-century history, we have the opportunity to reflect more critically on what Pride means in the world as it exists today, particularly within the reproductive health community.
While there are ways in which the growth of telehealth has removed accessibility barriers for many medically underserved folks seeking necessary care, COVID-19 has amplified the inequity in care for Black and Brown patients, which has already persisted for centuries. The inherent biases in our systems and the individuals who operate within them disproportionately affect People of Color, as they do LGBTQ folks, and particularly those who are not cis-gendered. As ever, reflecting on the intersectionality of injustice is a key part of Pride, even as we celebrate the patient-centeredness of treatment for many transgender, gender non-conforming, and non-binary folks during the pandemic.
We spoke with Dr. Natalie Hinchcliffe, MD, Associate Medical Director for Planned Parenthood Hudson Peconic and a provider of gender-affirming care, who says the transition to treating the majority of her patients in a virtual setting has been rather seamless.
“Telehealth provides a greater insight into patients’ lives because you get a view into their home environment,” she says, “it helps you relate a little bit more to the patient.” Dr. Hinchcliffe reflects that it feels refreshing to wonder how best to provide care in this new format, rather than whether or not one is able to provide it at all.
Nevertheless, as we take stock of the ways trans and GNC patients can now receive their essential treatment without the added burden of scheduling, transportation, and additional health risk, we must also own our responsibility as a movement of advocates, clinicians, and allies to call for the same equity for all people seeking comprehensive reproductive health care– many of whom have experienced prolonged neglect and mistreatment at the hands of the legal medical systems due to race, class, and other identifiers. In this way, to engage with Pride in 2020 requires that we demand more, rather than accept the steps we have taken so far.
Built upon the activism of queer People of Color, Pride holds different meanings throughout our culture, to members of the LGBTQ community as well as intersectional allies who hold the understanding that for one group to achieve justice, we must see that justice upheld for everyone. As we at RHAP continue to adapt to a working life marked by virtual community and telemedicine, we strive to celebrate the steps toward equity in health care brought on by telehealth, while understanding there will always be further to go in working toward an anti-racist and truly equal system.
Spotlight on a Cluster: New York
“Advocacy in the AAFP is a way for me to lend a voice to those who cannot. It provides the 10,000-foot view which helps put my daily practice in context and provides a platform at a local, state, and national level, where I can advocate on behalf of my patients and colleagues.”
– Ivonne McLean, AAFP Liaison, NYC Cluster co-leader, NYSAFP Board Member, Chair of NYSAFP Leadership Commission, and Young Physician Delegate to the AMA
2020 has become a year of change and adaptation. In May, the New York Cluster gathered to prepare testimony for the annual New York State Academy of Family Physicians’ (NYSAFP) Congress of Delegates (COD). Instead of gathering in Albany in June, as planned earlier, members will participate in the COD and provide testimony for resolutions virtually. During our meeting, we focused on the following resolutions: Remove the Title X Waiver; Support Family Physicians Providing Gender-Affirming Care for Youth; Confidentiality Protection for Non-Policy Holders in Health Care Billing; Resolution Against Criminalizing People Who Obtain An Abortion Across State Lines or Aid; and Support Full Coverage of Depo Sub-Q. Just this past week Cluster members mobilized to submit a new resolution calling on the NYSAFP to take a stand against police brutality and to support criminal justice reform policy.
Although meeting virtually was a big change from last year’s testimony prep workshop, the grounding aspects of sharing institutional knowledge, fostering mentorship, and providing feedback remained the same. Using Zoom break-out rooms, Cluster members practiced using a Resolved clause to anchor their testimony in personal experiences, shared values, and vision. Throughout the workshop, I was constantly reminded of the vital role administrative advocacy plays in the long game of reimagining health care in general, and reproductive health care specifically. Professional organizations are platforms to magnify our efforts and we are ready to take the microphone and shift the narrative, one resolution at a time.
-Hailey Broughton Jones, Organizer
Treating Ectopic Pregnancy in Primary Care
Ectopic pregnancies occur in about 1 out of 50 pregnancies (about 2 percent of pregnancies), but account for nearly 3 percent of maternal deaths. Ectopic pregnancies require urgent treatment. Quickly diagnosing and treating ectopic pregnancy is critical to preserving the safety and health of pregnant people. Training and supporting primary care clinicians to manage ectopic pregnancies can save lives and support healthy future pregnancies.
In May, RHAP’s medical director and two former fellows published “Ectopic Pregnancy: Diagnosis and Management,” an article in American Family Physician that outlines exactly how to diagnose and manage ectopic pregnancies in primary care settings. We have developed an info sheet that explains exactly what an ectopic pregnancy is, created an algorithm to help guide clinicians through the complexities of accurately figuring out if someone is experiencing an ectopic pregnancy, and published a clinical protocol that health centers can adopt that outline the best evidenced-based approach to providing this care. It is time for primary care providers to provide this critical care to their patients.
Now, when many hospitals are overrun caring for patients with COVID-19, managing ectopic pregnancies in primary care settings makes more sense than ever.
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