Another election year unfortunately brings another opportunity to publicly debate abortion. Not even three months in, it feels as though abortion is at the forefront of the media more than ever, thanks in part to Texas, the Senate, and 2016's presidential hopefuls.
I say unfortunately because having to once again view abortion as something political or moral — as opposed to what it is, something medical — delays progress for the entirety of women's health.
I spoke with a friend who currently works at an abortion clinic in the South:
"I don't think of myself as political or as an activist. As a future midwife, I just want to take care of women in all stages of their lives and support all reproductive choices. I get that it's a hot topic right now, but abortion is a very common medical procedure, and I wish my work in the medical field didn't have to be politicized. Because it is politicized, I still have to do things like walk to and from the clinic with a security guard, and park off-site. When I was applying for apartments, I couldn't put down where I worked because when I did, I was denied every time. It's frustrating."
This is happening in our country in present day, not fifty years ago nor in the third world. Abortion just one example of how women's health is inching forward at a snail's pace while incredible strides are made in how we view and treat medical conditions that affect both sexes. So how do we encourage greater progress with medical conditions specific to the female reproductive system?
We've got to start with the procedure everyone's talking about, and we've got to do it by reshaping the conversation.
Abortion is an aspect of women's health. Just as carrying a pregnancy to term requires sonograms, medical supervision, and use of medical facilities, so does terminating a pregnancy. They are two sides of the same coin. Abortion should also be covered by insurance, and the coverage offered should be decided by the insurance company, not the government.
These screenshots show how differently pregnancy and abortion are treated by my current healthcare plan:
State law has been the decider on abortion coverage since 1973, shortly after the Supreme Court's ruling on Roe v. Wade. Forty-three years later, we still must defer to state law for insurance coverage when terminating a pregnancy, but it's not just abortion that's affected negatively by this archaic way of thinking. State law is also the decider for coverage concerning all female infertility issues.
Only 15 of our 50 states currently provide insurance coverage for female infertility. As someone who felt the awful effects two different reproductive disease had on my body while I was not even trying to conceive, I know first-hand how a lack of coverage for infertility and the complex, little-understood diseases that cause it is dangerous to the overall health of all women. The medical industry is a business, and doctors (who want to keep their jobs) diagnose diseases based on what tests a patient's insurance will cover.
For example: My previous and current insurance plans do not cover any treatment for the two reproductive diseases I have, endometriosis and polycystic ovarian syndrome. To get better I had to go outside of my insurance plan to work with a doctor who was not hindered by what insurance does and does not allow re: women's healthcare. Most women do not have the luxury of going out-of-network completely, as I had to do, in order to receive healthcare that takes into account their specific reproductive organs as possible causes of illness.
Unsurprisingly, it's decidedly different for men's health. While state law hinders coverage and care for female reproductive issues, it promotes coverage and care for male reproductive diseases, like prostate cancer:
The difference between men's and women's healthcare is even more apparent, however, when researching coverage specific to vasectomies. According to vasectomy.com:
Not only are vasectomies well-covered by insurance plans, most states also offer additional financial assistance to men who lack funds to pay for the procedure (insert unbelievable amount of outrage for this double-standard here).
There are no state laws that interfere with a man's ability to get a vasectomy, other than many states requiring the man to be at least 18 years of age. Most state laws also encourage men to make sure their vasectomy is preformed by a well-trained, experienced urological specialist. (What's that? No talk of "back-room vasectomies"?)
Furthermore, vasectomies are covered by the nation's largest insurance provider, Medicare, while abortions are not (in accordance with another ridiculous legislative provision, the Hyde Amendment of 1977).
All of this to say, progress with women's healthcare is at a standstill when it comes to insurance coverage and the laws set in place around such coverage. We have to get to a point where all issues regarding women's reproductive health are addressed and covered by insurance policies as well as — or, imagine, even better! — than they currently are for men. Abortion should be covered just as well as vasectomies. Female reproductive diseases should be screened for and researched just as much as male reproductive diseases. Right now abortion is setting the tone for how everything else is treated, and that's why coverage and laws regarding abortion must change.
It should no longer be acceptable to search within an insurance plan to see what's offered for women's healthcare, and find three limited options, as I did today:
Putting all the emphasis on abortion detracts from other women's reproductive health issues that desperately need attention, research, and funding. Abortion is not the only reproductive issue not covered by insurance. As mentioned above, it's very hard to get any treatment or coverage for endometriosis and polycystic ovarian syndrome on most plans. Hormone replacement for women during menopause, hormone treatment for women with progesterone or estrogen dominance, and female sexual dysfunction are further examples of women's health issues not covered by insurance, and therefore not treated by most healthcare providers. Ovarian, uterine, and endometrial cancers—and their relationship to hormone imbalance and other estrogen-dominant diseases—still require a great deal of research. These are only a few areas of women's health that will benefit from extra attention and focus once we finally move beyond abortion.
We shouldn't care what politicians think about abortion, we should only care what they're going to do for women's healthcare. Politicians flip-flop on all issues, including the issue of abortion, based on what's best for their careers and campaigns, not what's best for women—not even what's best for the U.S. medical industry as a whole.
For a current example, we need go back no further than the 2008 presidential election, when Hillary said she was pro-choice, but would like to reduce the number of abortions, with the hope of reducing the number to zero. She called abortion a "moral" issue, hoping abortion would become, "safe, legal, and rare."
In 2016 Hillary's stance on abortion is decidedly more liberal (perhaps to match the stance of her current opponent, Bernie) and the words rare and moral have been dropped from her thoughts on the issue. Why has her opinion changed? Like any politician, her opinion is the one that will win her the most votes in the current moment.
(There's not enough time to analyze Trump's flip-flopping on abortion over the years.)
That's why we've got to stop asking all politicians what they think, and start asking them what they'll do. We don't need their take on whether abortion is "right" or "wrong." We need politicians and the law to recognize abortion as a necessary and common medical procedure, and then step out of the way. We also need future doctors, not future politicians and lawyers, to be the ones studying, researching, and improving abortion.
For my friend working at the abortion clinic in the South, her nursing curriculum (at a top school) included post-partum care, but post-abortion care was not taught because it is not a competency. Unfortunately, this is the rule, not the exception, when it comes to medical curriculum. Not only do we need doctors who are trained in preforming abortions, we also need doctors and nurses who are trained in post-abortion care and education. We do not need a future full of new lawyers trained to debate abortion, we need a future full of safer and smarter ways to terminate pregnancies, and more doctors who are able to provide such care.
Lastly, denying health care based on gender keeps the door open to deny other rights based on gender. If I had control over my life, I would choose a life free from ovaries and a uterus. I would also choose a life where I did not have to politically debate personal choices regarding my reproductive organs. I'd be paid fairly and my voice, experience, and opinions would not be belittled.
However, I do not have direct control over any of those things, but I do recognize that progress for women's healthcare means progress for equal pay, means progress for all women, means progress for the country as a whole. We have to use this year to get past abortion so we can finally get to everything else.
The next time abortion comes up in conversation, please debate it from a medical standpoint, not a moral one. Check your insurance plan to see what it covers for women's healthcare. Get angry about our limited options. Speak, act, and vote with that anger this election year.