Gals, Think With Your Lady Parts!

When women talk about a man’s bad behavior they’ll often say he’s thinking with his Dick. This is precisely how I feel about our new president’s intention to “dismantle Planned Parenthood.” In response, I am suggesting to all my patients and friends that it is time for women to start thinking with their Lady Parts, or shall I say, to quote our president, our Pussies. Gals, it’s time for our Pussie’s to work on our behalf and what better issue could there be for them to champion than access to contraception and sexual health care?

The idea of eliminating Title 10 funding feels disturbingly sinister, at the very least.  Approximately 75% of patients who rely on Planned Parenthood for care are low-income people. And while a few of Planned Parenthood sites do provide abortion services, many do not. In fact, Planned Parenthood reports that 97% of the care they provide is not specific to abortion. Actually, they offer life-saving services like PAP smears, HIV prevention and screening, contraception, and basic GYN care. Our president and vice president’s Throwing-the-Baby-out-With-Bath-Water approach based on their “Pro-Life” stance has raised my index of suspicion of one or all of the following motives: a war on low-income Americans, a poorly informed effort to reduce the abortion rate below its current lowest rate ever, a desire for involvement in people’s sex lives (Yuck, what a thought!) or all of the above. Should Planned Parenthood funding end then millions of low income people will not have access to reproductive and sexual health care at all. The outcome will be catastrophic and the impact of that catastrophe will largely be shouldered by poor women and their kids.

At present it is estimated that over 45% of all pregnancies in the US are unintended. These are the result of either a method failure or because of not having contraception in the first place. In either case, pregnancy can be both expensive and risky to a woman. This is especially true for low-income women who are more likely to be in poor health when starting a pregnancy than wealthier ones. My experience has shown me that poor women often end up bearing the burden of pregnancy complications and then caring for their kids with little physical or financial support from anyone. With few social programs being funded and low-income men having little money themselves, poor women are often left on their own to make ends meet. In order to stop this from recurring, access to affordable and effective contraception is paramount. And men, RARELY IF EVER assume responsibility for this. This includes choosing to have a vasectomy when they themselves don’t even want more children.  Men across class lines are so squeamish and protective of their penises that they refuse sterilization repeatedly. Despite the fact that most father’s today have witnessed their partner’s vagina performing extraordinary feats of accommodation in childbirth and are at least momentarily awestruck by the capacity and the pain it must cause, they still find the idea of a small snip and ice pack on their Dick’s just too risky or potentially uncomfortable to take on; more Dick thinking getting in the way of common sense, if you ask me. This leads to further reproductive burden landing on women’s shoulders.

I cannot count the number of times that a weary, exhausted, doing-her-best woman presents for a post-partum exam at 6 weeks after delivery and is pregnant. Why? In the words of one such patient: I just couldn’t argue with him anymore. He just wouldn’t give up! I had sex with him to get him off my back.  Many of you reading this will immediately jump to the conclusion that this woman should show her he-man bully the door and never open it for him again. Trust me though, this happens to women who aren’t poor but they’re much more likely to have adequate contraception on board when it does. When my higher class patients present for a post-partum exam and sheepishly admit to having succumbed to their partners’ hassling them, despite my advice to the contrary, their far less likely to be pregnant.  The reality in medicine is that women with more money are on the receiving end of more and better care which translates into more effective contraception. Health care providers, by and large, prefer caring for wealthier white women and earn more money doing so. Compare the salaries of clinicians who work for Planned Parenthood to those who work in a private or hospital-based practice and you’ll see what I mean. Folks that are on the front lines in a Title 10 clinic are activists who understand and deeply sympathize with what can and does happen to the poor if they don’t have access to care.  Should the president succeed in “Dismantling Planned Parenthood” he will create greater disadvantages to the very constituents he appealed to during his campaign. This is just too weird!

I encourage you to let your Lady Parts help you think about what a poor woman faces when it comes to childbearing and parenting. Think about how burdensome it must be to face an unintended pregnancy simply because you couldn’t access effective contraception or your personal values don’t allow for a termination of pregnancy. Then, imagine what could happen to you should you be in the position of having lost your job and health insurance at the same time that your prescription for the pill is about to run out. My guess is if you do, you’ll better understand the importance of not dismantling Planned Parenthood, at least not before you get to the one closest to you.

Copyright E. Resh, 2017.