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What Papayas Can Teach You About Reproductive Health Access

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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.

 

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