By Felipe on October 05th, 2020. Posted under: 2020
During my Ob/Gyn rotation last February, I met a pregnant patient in clinic. She was healthy and everything looked good for her anticipated delivery in a couple months. However, there was one fear this patient couldn’t overcome. She was terrified she was going to die during this delivery. Every day she woke up anxious that she wouldn’t make it through this pregnancy. My immediate internal reaction was confusion about why this patient was so worried about something that seemed extremely unlikely to me. In that moment, I reminded myself of the privilege I have as a white woman who could never understand what the Black patient in front of me was experiencing. In the United States, Black women are three times more likely to die during and after pregnancy than white women. As I was wondering why this patient was so preoccupied with the fear of dying during pregnancy, this woman was facing the very real fact that she was at an increased risk of death due to the effects systemic racism have had on her throughout her life.
Kristen at the 2019 MSFC Conference on Family Planning
After the murder of George Floyd in May, I learned Medical Students for Choice was starting a Racial and Reproductive Justice Reading Group for its members. I felt obligated to continue to educate myself on the issues and disparities existing in our country, acknowledging that my Black peers have not had the choice to solely “educate themselves,” but have been forced to reckon with racism for their entire lives. I decided to participate in the first reading group session. At the beginning of the session, we watched an interview with Loretta Ross, who is one of the creators of reproductive justice. The tenants of reproductive justice are as follows: all women and individuals with a uterus have the right to have children, the right to not have children, and the right to raise children in a safe and healthy environment. This concept has revolutionized my perspective and put a name to my beliefs in racial, social, and environmental justice in combination with reproductive health.
During the reading group, I listened to the perspectives of my peers from different backgrounds in addition to sharing my own ideas. We talked about patients similar to the one I encountered in my OB clinic. We discussed the necessity of advocating not just for white women, but in particular for our Black patients, our LGBTQ+ patients, and our patients with disabilities, to name a few. As someone who identifies as pro-choice, these discussions, videos, and readings led me to challenge and re-evaluate my ideas. There is so much more to reproductive justice than just being pro-choice: only being pro-choice isn’t enough. Many individuals throughout history and today do not have a so-called choice. Black, Native, and disabled populations, for instance, have historically experienced coercive medical and reproductive healthcare. Even today, we are seeing reports of non-consented hysterectomies in immigrant populations. As a future physician, it is important to be cognizant of people’s experiences and histories both within and outside of the medical system.
My experiences participating in the first session motivated me to facilitate and plan some of the discussions. The reading group has also impacted my school’s MSFC chapter’s work. At the Indiana University School of Medicine Indianapolis MSFC chapter, we are expanding our discussions to include topics like reproductive justice and racism. In addition to advocating for the inclusion of abortion in our curriculum, we are advocating for the removal of concepts rooted in racism, such as the idea race is a risk factor for disease. We want current and future IU students to learn this information as part of the standard curriculum instead of having to seek it out on their own.
As a medical student, I am constantly reminded it is impossible to know everything. However, we can learn from the experiences of others and continue to educate ourselves. The Racial and Reproductive Justice Reading Group provides a space to learn in a community with other medical students about topics we might not discuss as part of our schools’ curricula, and gives us the inspiration and tools to work on changing that. It is not easy to confront our own existing biases, but I will be a better doctor because of it. In a system that attempts to control the reproduction of Black patients, I will continue to talk about reproductive justice with my peers and patients, and in doing so, I hope to make a change within the medical field and society as a whole. Our fight for the fullness of true reproductive justice continues. 
By Felipe on July 07th, 2020. Posted under: 2020
The bulletproof glass doors were installed in 1988. They swung open before me as I entered the Boulder Abortion Clinic and began a hugely formative chapter in my medical training. During this time that I spent as a first-year medical student observing abortion care that ranged from the first to the third trimester, I was thrust into the personal, intimate details of the lives of each of our patients. From the 12-year-old girl abused by her family member to the 38-year-old mother of three who traveled from Europe after learning about her fetus’s anomaly, I gained a profound appreciation for providing nonjudgmental and compassionate care to anyone who walked through those same glass doors. At the same time, I began to cultivate the seeds of dedication, sacrifice, and unyielding passion demonstrated by each individual at the clinic that continue to inspire me and embolden my enthusiasm for a future in women’s health.
Jessica Chen, MD
Upon arriving at the clinic, I was warmly greeted by each staff member who ensured I would feel not only safe but supported. Each week was filled with a deluge of emotions, stories, and warmth while staff members carefully counseled patients during hour-long sessions and through oftentimes heart wrenching or sensitive decisions. “Shout Your Abortion” pamphlets or books nurturing healing after making the difficult choice to have an abortion were readily distributed to patients who desired their contents.
Dr. Hern, a prolific writer and committed educator, maintained the difficult and delicate balance between communicating to his patient and edifying me on his technique and decision-making processes. Outside of the examination room, he showered me with reading material, topics of interest to him in the news, and experiences he has accumulated traveling the far-reaches of the globe and providing care for women over the past fifty-plus years of his life. Dr. Hern taught me to be a safe, thorough, and caring physician while at the same time fostering in me a sense of responsibility to speak out for what you believe in, advocate for those in need, and research for future change.
When it came time to depart, I had planned on a courteous and swift goodbye as my flight was to take off directly after clinic ended on my last day. As I went to thank Dr. Hern and his staff for the time we had spent together over the past three weeks, I felt my throat tighten as tears began to spill from my eyes. As I was utterly shocked by this reaction, I began to profusely apologize for my elaborate display of emotion, but Dr. Hern simply shook my hand knowingly to dismiss my apology, easily understanding and perhaps even anticipating my reaction, however surprising it may have been to me.
Four years have passed since I first entered the Boulder Abortion Clinic and met Dr. Warren Hern, the trailblazing, dedicated, and now-octogenarian physician still practicing at the Boulder Abortion Clinic, which he founded 45 years ago. I am now about to embark on the next chapter of my career as an OBGYN resident with plans to pursue a fellowship in family planning. I have no doubt that the time I spent at the Boulder Abortion Clinic will stay with me throughout my career, and for that I am tremendously grateful to Medical Students for Choice, Dr. Hern, his staff, and each patient I was lucky enough to meet in the small, brick clinic nestled against the Front Range of the Rocky Mountains.
By Felipe on May 08th, 2020. Posted under: 2020
As abortion access around the world is impacted by the COVID-19 pandemic, MSFC chapters have risen to the challenge to serve their communities. From providing childcare to healthcare workers, to delivering medications and supplies, to serving as reproductive health educators online and via hotlines, MSFC members are filling the gaps and stepping up during the pandemic.
University of Iowa: Supporting Local Abortion Clinic through Medication Delivery
Iowa faced a moment of unprecedented challenge to abortion access when Gov. Kim Reynolds banned elective procedures including surgical abortions (luckily, this has not been upheld). MSFC members were prepared to engage politically, but since have been doing on-the-ground work to help patients in their communities. The chapter’s education chair, Joanna Silverman, came up with the idea for a program to deliver medications for their local abortion clinic.
MSFC member Emily Trudeau shares, “We cleared the legalities through our school and are now providing a service where we can deliver medications (birth control, etc) to patients who are unable to get to their medications for whatever reason.” They also have a doctor on standby to help with birth control prescriptions!
Stepping in to Fill Staffing Shortages in Detroit
Dozens of MSFC members have stepped up at clinics across the country to fill staffing shortages caused by COVID-19. Amanda, an MSFC member in Detroit, Michigan, has been a major coordinator of this. Amanda shares, “I was lucky to be doing my last rotation at an independent abortion clinic when clinicals were cancelled. The clinic had 4+ people quit the one clinic in a matter of days, with no prior notice. So, the doctor I was working with asked if I wanted a job, and I’m now working there full time until residency starts. Clinics all across southeast Michigan are having a huge staffing shortage due to people fearing a COVID infection and quitting (although the clinics are taking proper precautions to protect employees). Since then, we have gotten 10 more MSFC med students hired at different clinics in the area. We’re directly helping [as clinical assistants] to provide care and keeping the clinics open.”
Sex Ed on Social Media
Following mass unemployment and loss of health insurance, many more people are turning online for reproductive health information—especially youth. Using social media as a platform for sharing reproductive health information is a great way to fight stigma and help friends and family access accurate information. Member Bella served as a sexual health educator before medical school and has used Instagram Stories to cover some of the most frequently asked questions. Member Jill volunteers with her local Planned Parenthood’s text line, where teens and young adults can submit questions about reproductive health. She’s also provided sex ed to high school students. Jill started doing “Sex Ed Sundays” on her Instagram Stories to myth bust and engage her followers. The response has been positive, and they’ve both become a trusted source of reproductive health information in their networks!
Remote Chapter Events
Even if MSFC chapters can’t host meetings in person, they are continuing to further MSFC’s mission to create the next generation of abortion providers by hosting online events to educate classmates about abortion and reproductive health. MSFC’s Medical Director, abortion provider and MSFC founder Dr. Rachael Phelps, is teaching webinars for chapters around the world. Some of her more popular presentations include Unintended Pregnancy and Abortion by the Numbers, and Top 10 Myths about Abortion. A student at one of our southern chapters had this to say about her chapter’s event with Dr. Phelps: “[The] remote workshop filled a wide gap in my medical education. I think being remote meant more members were able to attend and help facilitate a very meaningful discussion.” In fact, many chapters are reporting a turnout for online events comparable to in-person events! If you’re a med student and want to schedule an event with Dr. Phelps or brainstorm how an event can be done virtually, email students@msfc.org!
These are just a few of the ways our chapters have been responding to the global pandemic. If you want to learn about other projects, share your work, or brainstorm ideas, reach out to us at students@msfc.org. We are always here to support you!
By Felipe on February 07th, 2020. Posted under: 2020
Papayas can be named by color: green papaya, golden papaya, “sunrise papaya”. Sometimes they are named by origin: Hawaiian papaya, Mexican papaya, Brazilian papaya. Sometimes—innocently—they are just named “papaya”, and you have to call the manager over the intercom at H-Mart and interrogate accordingly.
My expertise in papayas has been an unexpected side effect of my medical education. At Medical Students for Choice we use papayas as model uteri to teach procedures like abortion and IUD placement. I have been a pro-choice advocate my entire life, even forgoing a traditional social science curriculum in my senior year of high school to pursue an independent study in reproductive justice. However, it was not until my first year of medical school that I had any practical knowledge of abortion care. At my institution, it was MSFC I had to thank for educating me.
Chiara Heintz, MSFC Experienced Student Leader
In the United States, nearly 20 percent of medical schools report having no formal teaching on abortion. Though my school does have one week allocated in our preclinical years to learning about sexual health and sexuality, unlike all other weeks of the school year where we are tested on everything from rare genetic disorders to the innervation of the pinky toe, we are never tested on abortion care. In a system where we are taught to respect and prioritize test-taking, what initially seems like a welcome respite from exams is instead a message that this material is not as important as the rest of our curriculum.
Papaya workshops attempt to fill that gap. After attending one during my first year of medical school, I knew that being involved with MSFC would allow me to be on the ground giving my fellow future physicians the relevant information they needed to take care of their patients, regardless of what specialty they pursue.
The lack of knowledge among healthcare providers about a procedure that 1 in 4 women will get in their lifetime is harmful to patients and unacceptable to me. And, with a conservative majority Supreme Court and states curtailing abortion rights, this work feels more urgent than ever. This is why I am an expert on papayas: because I think that all patients deserve healthcare providers who are experts on their care.
In my tri-state area-wide search for the perfect papaya (see below for the requirements), I’ve had some uncomfortable and bewildering conversations with cashiers and managers. I’ve scoured the produce departments of more than 10 grocery stores. I’ve driven from the Asian Food Mart in Piscataway, where I raised suspicion by requesting 35 papayas, to the Star Bazaar in Somerset, where I triumphantly found 13, and even ventured to Manhattan to round out my supply.
Here’s the thing: This whimsical grand adventure I am on in which I drive, in my own car, from nearby well-stocked store to store, ready to use subsidized funds to buy a morally neutral item that at worst will yield an awkward interaction with a cashier is frustrating. It is disheartening. My back hurts from carrying bags of papayas, I’ve had a long day, and I don’t even like papayas.
Fortunately, New Jersey does not have any of the major legal restrictions such as waiting periods or mandated parental involvement policies that are often found in other states. Still, in 2017, one third of New Jersey counties had no clinics that provided abortions, and one quarter of New Jersey women lived in those counties (Guttmacher).
But this is not even a fraction of what folks, with much more at stake, experience when they try to access reproductive care in the United States. Today, 12 states restrict coverage of abortion by private insurance. 19 states require that an abortion be performed in a hospital after a specified point in pregnancy, rather than a clinic or doctor’s office, which has been shown to be safe, comfortable, and less costly in the states that allow it. 14 states require a woman to make two separate trips to the doctor to have the procedure (Guttmacher). That’s two days off from work, two days of paying a babysitter… you get the point.
And once you add in the pro
testers camped outside clinics, crisis pregnancy centers, and misinformation from a largely nonexistent sex education system, you are left with even more obstacles to access.
This is why I am an expert on papayas: because when a patient arrives in my office, after overcoming all of those obstacles as they navigate through a broken system, they deserve someone who knows how to take care of them.
For the record: you want a light green (fading from dark green as it ripens), small, Hawaiian papaya, a manual vacuum aspiration kit, a trained abortion provider willing to teach, and a willingness to learn. Your patients will thank you.
