Please, Have a Conversation...

Most Iowans I talk with are surprised to learn that we are 48th in the country in terms of access to family planning and birth control. I was surprised, too. In Mt. Pleasant I lived three blocks from the Southeast Iowa Planned Parenthood clinic, so I thought everyone else in Iowa had access.

The Iowa Department of Public Health contracts with Iowa Rural Health Clinic Providers to deliver primary care, including reproductive services. Women on Medicaid can get reproductive health services at these rural health clinics in counties where there is no family planning clinic. I have come to realize that access is more complicated than that.

In cities like Des Moines or Davenport a woman might not have access if she has no car and the local bus doesn’t stop near a clinic. Recently the Visiting Nurses of Des Moines opened a family planning clinic at Park Fair Mall Shopping Center, right next to the Fareway grocery and the Walgreens pharmacy on the local bus line.

In fact, they advertise in the Des Moines buses. The ads are important because if women don’t know about the three new kinds of long-acting reversible contraceptives, then they aren’t really accessible.

If a woman lives in Lyon County or Taylor County and there are no family planning clinics within 30 miles, then access is a problem, because most women work, sometimes on shifts that make it inconvenient to access birth control and reproductive health services on a regular basis.

Because of Iowa Initiative grants, existing clinics are opening satellites. A few weeks ago Northeast Iowa Community Action opened clinics in Postville, Fayette and New Hampton. Next week we’ll be opening Planned Parenthood of Greater Iowa clinics in Creston and Ft. Dodge.
Access also includes access to information. We created the first comprehensive map of family planning/birth control clinics in the state, so that anyone visiting our website may click on the town where they live and get contact information. In some cases they can make an appointment online. The Initiative also created a comprehensive chart of all hormonal and non-hormonal birth control options now available in most clinics across Iowa. It's also been translated to Spanish, because language can be a barrier to access.

When I was newly married, I was making $7,000 a year as a teacher in small town upstate New York. I had health insurance, but it didn’t cover birth control. I couldn’t afford to be pregnant those first three years of marriage, because I was supporting us while my husband finished law school. The nearest family planning clinic was 30 miles away, but that’s where I had access to low-cost birth control pills and a yearly check up. If a woman has no health insurance or has health insurance that doesn’t cover birth control, access is a problem.

Today the Pill can cost between $30-50 a month. College students and many women working minimum-wage jobs, simply can’t afford this expense. Iowa Initiative grants make long-acting reversible contraceptives (LARC) available at no-cost or low cost at every family planning clinic on our map. So far the best advertising for new clinics and LARC in Iowa is word-of mouth: roommates sharing information; daughters telling their moms; health care professionals counseling clients.

Please have a conversation with someone else about what you learn here.

If the President-Elect Can Talk About It, We Can Talk About It Too

Barak Obama, our new president-elect, co-sponsored the HR 1709 [109th]: Prevention First Act in the Senate during the 2007-2008 Legislative Session, a bill which seeks to expand access to preventative health care services that reduce unintended pregnancies, reduce the number of abortions, and improve access to women’s health care. President-Elect Obama talked openly about issues regarding women’s reproductive healthcare during the campaign, concentrating on reducing unintended pregnancies. This bodes well for the future of issues covered in the Prevention First Act.

Yesterday’s election is promising for those of us committed to starting community conversations about how we improve access to birth control and reproductive health services for adult women. If our next president can talk about it, so should we.

HR 1709 [109th]: Prevention First Act Summary: The bill includes provisions to:

• Increase access to family planning services through the national family planning program (Title X) and allow states to expand Medicaid family planning services to women with incomes up to 200 % of the federal poverty level.


• Ensure that private health plans offer the same level of coverage for contraception as they do for other prescription drugs and services.


• Ensure that women who survive sexual assault receive factually accurate information about emergency contraception (EC) and access to EC upon request.


• Support state-level comprehensive sexuality education programs that include medically accurate information about abstinence, contraception, and disease prevention.


• Implement important public education initiatives about EC and its benefits and uses to women and medical providers.


• Enable competitive grants to public and private entities working to establish or expand teen pregnancy prevention programs.


• Require that all information provided about the use of contraception as part of any federally funded program is medically accurate and includes accurate information.