Planned Parenthood Ain’t Abortions
During my OB-Gyn rotation, I’ve been working with the great staff of our local Planned Parenthood, and let me just say: Planned Parenthood rocks.
I will admit, fully ignorant of Planned Parenthood beforehand, I thought I’d be doing abortion evaluations. Planned Parenthood equals abortions. That was the extent of my knowledge. I spoke with friends–well-educated, public health-type friends, and that was their same response. “So, did you do any abortions today?”
I was so far, far off base it’s not even funny.* In fact, it may sound ironic, but I’m pretty confident when I say this: No matter what your feelings are about the subject, there would be more abortions performed in this country if Planned Parenthood didn’t exist. Let me explain.
The patients I’ve seen have been, in general, young, healthy women, ages 12 to 26. They come in primarily for three things:
- annual exams (pap smears, breast exams, etc.),
- sexually-transmitted infection (STIs) diagnosis and treatment,
- and birth control.
I see patients of all socio-economic statuses, but most are immigrants or lower-middle class women. Their health knowledge runs the gamut, from the highly educated 12 year-old I saw today, who curiously asked “how exactly do the birth control pills work?” to the 23 year-old who shrugs and answers questions with a dull, empty look on her face. Almost every single one uses some form of birth control.
This makes sense. Over 90% of women of childbearing age use some sort of contraception method. I quickly became aware that my male gender has allowed me to pass through medical school (and life!) totally ignorant of all of this. My patients came in using almost everything–condoms, the pill, the patch, Nuvaring, Depo–and I was left perplexed. What a humbling role reversal–this was one of the first times it’s been so painfully obvious that my patients are more informed about their health and medicines than me. (This also made me realize that I generally assume I generally know more about medicine than my patients.) Not that the pharmacology or physiology is at all complex or difficult–just that the topics had never really come up before. Birth control was birth control was birth control.
I’ve been having a fantastic time at Planned Parenthood–I’m able to perform a number of pelvic exams and get a good sampling of “normal variation,” and probably the harder part–I’m able to talk very candidly with my patients about their sexual health. It’s great practice just to get used to figuring out how to talk about “sexual activity” and “sexual intercourse,” because it certainly takes practice. You have to unlearn (or at least disengage) the typical social cues in your head that encourage you to avoid the subject or the word, especially since almost none of my patients have had any complaints or concerns with their sexual health. It’s great to see patients in an environment where discussing sexual health is the norm, as it also helps bring a level of normalcy to the encounter.
We give out a ton of contraceptives every day. Condoms, pills, patches, rings, shots. And none of the patients I’ve seen are taking these medications for anything other than preventing pregnancy. They are sexually active, almost always with one, monogamous partner, and they do not want to get pregnant. And by enrolling these largely uninsured teens and young women in California’s Family PACT program, we’re able to provide them with free contraceptives and reproductive health services.
55% of pregnancies in the US are unintended, and of these, 43% are live births, 43% are terminated electively, and 13% end in miscarriage.
All the women I see in clinic are sexually active. And most are working or middle class at best by income standards (the average 2 bedroom apartment in the area runs you at least $1400 a month), most are uninsured, and most do not have another source of medical or reproductive care. And none want to get pregnant.
Now just take away Planned Parenthood, add in the costs to see a health care provider and pay for contraceptives, and imagine how many more of my patients would become pregnant. Keeping everything else the same, you’d find many more women in the difficult position of considering an elective termination of pregnancy.
I am far from zealot or activist–as I said before, I knew nothing before a few weeks ago–but I’ve been incredibly impressed with my short time there, and I’m hoping I’ve educated you as to what Planned Parenthood does in your community, since I was woefully ignorant myself.
*Planned Parenthood provides reproductive health services, annual female gynecologic evaluations, breast exams, pap smears (and management and followup of abnormal pap smears), the HPV vaccine, STI testing including HIV, emergency contraception, vasectomies, patient education–the list goes on and on.
I am so glad you shared your perspective on this! I have known what a great resource PP is, and have even helped some friends with transportation to the nearest clinic.
I was and still am angry over this lame “Rider 8″ legislation here in Texas which forbids any public funds going to a health service provider that provides abortions. Even though Planned Parenthood never mixed public and private funding and abortions were only financed through private funds.
It’s so ridiculous, because you’re absolutely right in that Planned Parenthood’s services are preventing a whole lot of unintended pregnancies. They’re doing more than those right to life activists.
Where has this gotten us? In my search for information about the latest on Rider 8 (which i couldn’t find anything more recent than 2 years ago), I found this lovely gem.
Texas Tops U.S. in Teen Birth Rates
http://tinyurl.com/2o7ujf
Hmmm… I wonder what the connection here is.
Thanks so much for sharing this story. I’ve been involved in volunteering at and supporting Planned Parenthood for years.
I’d just add how wonderful the people who work at these clinics are. They experience harassment of all kinds, need multiple security measures just to do their jobs, and yet they do them with cheerfulness and compassion. I’ve been so impressed with the dedication of my local PP staff, from the security guards to the nurses to receptionists and administrators.
Its important for people to remember that family planning isn’t just about women (though even if it was, it would still be necessary). PP’s services keep women healthy, and by extension, their present and future children, their families, and then their communities.
So thank you for writing this. I hope time working at PP provides similar experiences in others. And thank you for helping PP do the work they do.
yours,
M
My wife has gone to PP for as long as we’ve been sexually active together, also in Texas. When she started, one month of pills was $9 through the clinic, with a required annual exam (now called a “well woman exam”). The prices have gone up in the last few years–to 15, 22, and 32 dollars. We recently moved to Houston, and when we got here, she scheduled an exam at the Houston PP. Everything went well, but unfortunately, they do not provide pills in this city. They are fifty-something a month through CVS (no insurance right now), and $35 through her grad school.
I haven’t heard about “Rider 8,” but I wonder if that’s the culprit?
Thank you for your blog entry about Planned Parenthood. I wish more people understood what they did. I am a woman in my early 30′s who has 2 masters and works professionally. Planned Parenthood in California helped me make sure I didnt get pregnant in my late teens and early 20′s when I was going to school and working a minimum wage job so I could have a future!
Thanks for acknowledging that Planned Parenthood fills a vital role in the public healthcare system in this country. At every turn, they are first and foremost an advocate for women’s health. In addition to the wonderful and needed health care they provide, the PP in my town also provides adoption counseling services to pregnant women.
[...] by Rachel on October 4th, 2007 Med student blogger “Over my med body” learned a few things during his rotation through a Planned Parenthood clinic: All the women I see in clinic are sexually [...]
Just another person who wants to thank you for sharing your experience at PP. They are just an amazing resource and in my (vast) experience with different medical care workers I have never run across more understanding and non-judgmental people. That makes a BIG difference when the subject is something as sensitive as one’s sexual history and practices.
I wanted to thank you for this. I was born and raised in a Catholic household where Planned Parenthood=the devil, because nobody cares to understand how much good Planned Parenthood does for people. I will admit that when I was younger I did my share of protesting against Planned Parenthood, because all I had heard about it was the uneducated less than understanding view of PP from Catholics. However, I’ve learned more over the years and actually donate money out of each of my paychecks to Planned Parenthood because I see what a service they are. I really appreciate seeing someone who works there saying that I am right and it really is a service to the community and does a lot of good to prevent pregnancies. I’ve always tried to tell people that that is what planned parenthood is there for, to help people plan when they want to get pregnant and avoid pregnancy until then, not to end pregnancies, and yet I’ve never found anyone who seemed to get that till now.
Great post.
Well, sounds like working at PP has been a very eye-opening experience, and I’m really glad you’ve had it. It will help make you a more well-rounded doctor, and maybe one who’s more in touch with the concerns and needs of his female clients of reproductive age. Birth control is birth control is birth control…something you’ve never had to think about very much because you’re a guy, and birth control is a woman’s issue (or responsibility)? Three cheers for education! Thanks for posting about this.
Excellent post! The PP in Bryan-College Station used to get protesters every day, including “Free Pap Smear Day”, when volunteers would come in to perform pap smears on women who otherwise couldn’t afford them. Local anti-PP mouthpieces said this service was “encouraging promiscuity”. I’m glad you have learned so much from your time at PP, and I hope you can share your experience with your friends.
I just wanna give a shout-out to the Mirena hormonal IUD: Light periods, 99.9% effective, you don’t have to remember it, and it only needs to be changed 1 time every 5 years. If you want to get knocked up, have the MD remove it and voila! you’re fertile. No need for monthly payments for birth control pills or whatever.
Tell everyone everywhere.
What a fantastic post. I love hearing about aha! moments when some group different from us is suddenly humanized as we find out more about them.
Was your Planned Parenthood rotation an elective rotation? I totally want to do one.
Great article. I became slightly aware of those services during the ongoing Planned Parenthood clinic opening in Aurora IL. Those protesting fools are blinded by their zealotry to the benefits to their community that Planned Parenthood offers.
The Mirena is also several hundred dollars and painful to have inserted, and can expel pretty easily. Many insurance companies do not pay for follow-up visits for IUDs, and if it expels, you cannot get another with insurance for awhile.
Thank you! Thank you! Thank you! This post is much appreciated.
If I understood your post, you are seeing sexually active 12-year-old girls at Planned Parenthood. I am really glad that you are helping these girls not to get pregnant or diseased. However, having sex is not good for12-year-old girls – this situation is damaging them emotionally and physically.In my state, I believe sex with a 12-year-old is a crime.
Do you have any moral or legal responsibility to report this to police or child protective services or otherwise help them?
I have the same question as anonymous. Do you really treat “sexually active” 12 year olds? I am concerned that this 12 year old is not sexually active but rather sexually abused. Please help her– and that does not mean merely ensuring that she does not get pregnant while some older male takes advantage of her.
I’m a big PP supporter, both as a patient and a donor. They’ve treated me with more respect than any other gyn I’ve been to. They gave me my much-loved IUD when my ex-gyn wouldn’t.
But, I’m also curious about the 12 year old(s). I’m not assuming that it’s abuse by an older man — I know coitarche is disturbingly young in some communities, and it could easily be with a classmate. I’m just curious how many girls this young you see, and what you do differently, and so on.
“Over 90% of women of childbearing age use some sort of contraception method. I quickly became aware that my male gender has allowed me to pass through medical school (and life!) totally ignorant of all of this.”
Presumably your gay orientation also helped? A man with female partners of childbearing age may shy away from the details but is certainly privy to his partners’ anxieties. I’m bi, and for ten years had exclusively women partners. When I started dating men again the monthly anxiety returned. No matter what I was doing for birth control (and I always was doing something), every month I would worry and fret until I got my period.
My current partner has a vasectomy and it’s like being with a woman again. Blessed relief!
[...] received more comments on my Planned Parenthood post than any post in a long time. Thanks! A bunch of people had questions about minors and sexual [...]
I couldn’t help rolling my eyes when I read your response to comments about ‘sexual activity with minors’.
‘…the area does not believe that mandatory reporting is good for its community…’ Puh-leez! The ‘community’? How collectivist of you! What about what’s good for these sexually active minor individuals? Your answer was a cop out. You rationalized and justified your lack of legal accountability. What about your moral conscience? I would be ashamed, as a physician and educated adult man, to look a 12 year old girl in the eye knowing that she was engaging in damaging and potentially dangerous sex and that the best I could do was recommend effective birth control.
You have power to do good. You should seize it.
I’m a longtime supporter of and clinic escort for Planned Parenthood – they do more to support women and protect children in a day than all the anti-choice protesters in their lifetimes. It’s exciting to see someone on a rotation ‘get it’. It has always bothered me that so many medical students simply don’t get good education in medical school re: family planning and abortion care.
One would think doctor-patient confidentiality would prevent a doctor from reporting a patient to the authorities unless you’re sure a crime has been committed. While it’s not ideal to have a 12 year old girl having sex, give the girl some props for being smart enough to go to PP and think about her sexual health. And keep in mind that if PP starts reporting every sexually active kid who walks in the door, those sexually active kids will stop going to PP.
Anon: It’s not really under my control when counties outside of my own, where I do not work, choose to obey a law differently, and the story is much longer and involved than that–no reason to attack me for giving a brief answer to a long, complex issue.
[...] sentiment is echoed here and [...]
[...] received more comments on my Planned Parenthood post than any post in a long time. Thanks! A bunch of people had questions about minors and sexual [...]
I don’t want PP to “report every kid who walks in the door”, but I can not help worry about a 12 year old girl who needs birth control pills. Is this a unique situation or did you have other patients this young? Is there a lower limit on the age of girls that you prescribe b.c. pills to? Did this 12 year old get herself to PP or did some adult bring her in?
I have no personal experience with PP and your post has left me with several other questions. Do patients of PP clinics have a choice of doctors ? I always use seasoned female gynecologists, would I be able to find such a doctor at PP? Your post makes it seem that PP is as much about giving you experience in giving gynecological care as it is in women receiving that care. This observation is in no way a criticism of PP or you, I’m just wondering if PP is part of the tradition of new doctors “practicing” on the poor? How often do middle class women with private insurance use a PP clinic?
I’ll refer everyone to my privacy policy and leave it at that. I heart HIPAA.
If PP is part of the tradition of new doctors “practicing on the poor,” then my clinic at Stanford is often the tradition of new doctors “practicing on the rich.” Medical students, interns, residents, and fellows “practice” on everyone.
My particular PP is staffed by non-MDs, you’ll need to check with your local PP for its staffing.
(And of course–most of my posts are about my experiences learning how to provide medical care–that’s what the blog is about!)
[...] 11, 2007 via Our Bodies, Our Blog comes an awesome blogpost from med student Graham Walker about what he learned while doing ob-gyn rotations at Planned Parenthood. It’s pretty [...]
No where did I read anything in this post that specifically said that 12-year olds were being given. I did see a sentence that said all the “women” this doctor has seen at this PP were sexually active I’m not sure that the term “woman” was meant to encompass 12 year olds in this post.
Additionally, my daughter has been on depo provera since she was 12. There are other medical conditions that can be treated with off-label uses of hormonal contraceptives. In my case my daughter began menstruating when she was 9. By 12 she regularly complained of severe pain and abnormally heavy periods, nausea, vomiting, etc.. She was diagnosed with endometriosis and was put on depo provera because hormonal contraceptives are quite effective at treating endometriosis. The depo provera allows her to not menstruate which lessens the endometriosis. Additionally, we’ve also utilized PP because they have great classes for teens about their reproductive health that IMO all females should be learning the minute they become capable of becoming pregnant. Educate yourself a little before you decide that every 12 year old that goes to PP is sexually active.
Wow, thanks for the great report. Keep up the good work!
To the reading-impaired anon posters? How do you live in this society with this sort of selective parsing?
Patients – 12-26 in general. (Population 1)
90% of women of child-bearing age are on birth-control.(Population 2)
These two groups are almost totally independent of each other! Learn to read!
One, ONE 12 year-old asked the question “How do birth control pills work?” and all of the sudden everyone is up in arms.
It’s no wonder red-state teen pregnancy rates are far and above blue states, when useful questions like these are met with hysterics.
Rant off.
I’ve gone to Planned Parenthood for about 20 years for my regular annual GYN care. I like the more open-minded approach I have always found there. I’ve been to GYN clinics of theres in several states and always been satisfied.
Adding my .02 – early in my career, I couldn’t afford any other option. And you’re right when you say PP prevents more abortions than they’ll every do. This country is in deep trouble when we don’t support women’s access to reproductive health care – in ALL forms. The TRUE separation of church and state would see to it.
Anon- You’re saying there ought to be a age limit on birth control prescriptions? PP can’t control her sexuality, it can, though, help to prevent pregnancies. I’d rather see a 12 year old with birth control than a 12 year old with a son or daughter, wouldn’t you?
Then there’s the doctor patient confidentiality thing. It’s a legal requirement because if it weren’t, girls would be scared off of seeking medical care.
Finally, it’s unlikely the doctors or nurses at PP would be able to prove the kid was actually sexually active (instead of just considering it), and even if they could prove it, why would the 12 yo give the doctors’ her boyfriend’s name? Without a name and proof, there’s not much a person can do.
Haha–yes, sometimes your patients will know more than you on a particular topic or topics. :) Great post.
It’s amazing how the question of “how does birth control work?” from the 12 yr old some how gets translated into “I’m a sexually active person who needs birth control!”
I know there are some horrible realities out there, but y’all are REALLY jumping to conclusions here. She could’ve been someone’s curious daughter, niece, cousin, or sister. She may have need b/c for some other, non sexual, reason.
Please ppl! Calm down!
Thank you so much for your post! I have often told people of all of the different and highly beneficial things Planned Parenthood does for its communities when it comes to health care. This is definitely going to educate those who don’t know what Planned Parenthood is all about!
[...] student, who is in fact male, is doing a rotation at his local Planned Parenthood. In his post, Planned Parenthood Ain’t Abortions, he sets the record straight when it comes to Planned Parenthood and what the clinic does. He even [...]
http://www.ms4c.org medical students for choice
Awesome…sounds like ALL doctors should volunteer at a PP…period.
It’s quite the leap to assume that a 12 year-old curious as to how the pill functions is sexually active. She could be having painful, heavy periods which hormonal birth control often helps. I’d rather her learn how the pill works and know how her own body works from a medical professional than in the school yard.
Also, don’t many public schools give sex education that young? I know by age 11 I at least had sat through the school nurse coming into class to tell all the girls about menstruation.
I WISH I’d had the option of PP sooner. They saved my cookies with an abnormal pap which turned out to be stage 3 pre-cancer!
Thanks for the post, Graham. Keep up the good work.
Wonderful post, fascinating discussion, but I just wanted to say that I’m so glad there are doctors (or future doctors) who know that (some) patients really know their meds, how they work and why we take them. I’ve not returned to more than one Doc because they didn’t understand this.
Interesting story from the main Houston PP :
Two days ago, I got tired of seeing protesters out there, scaring women. It’s a terror tactic, obviously. So I thought I’d go have a chat with them, to ask them if Christ was a terrorist.
They told me they were just there to pray.
“Oh”, said I. “What about Mathew 6:6?”
They didn’t know that verse (Christ’s reply to people praying for attention, as opposed to intercession). Look it up. It’s highly relevant. I prayed with them. They were a little shocked that a baptist was reciting the Lord’s Prayer in Latin, but that’s neither here nor there.
Anyhow.
I decided to take pictures of their license plates. I may have mentioned something about my curiosity as to how their “neighbors and coworkers would react to knowing what you do with your off hours”. This did not please them. But as they were parked on a public street….
I got all 15 of their plates before the cop rolled up. They’d called the police. Why? Beats me.
The cop cuffed me, told me I was going to jail, put me in the cruiser, took me 3 blocks away, stopped the car, and asked me where I live. I told him. He took me there and un-cuffed me. He was laughing his ass off at the picture idea. I’ve already emailed them to him, at his request.
How cool was that? You know the tide is turning when Houston cops are pro choice.
What an amazing thread/service! To be fair, I have not read all the replies, I have just finished working a 13 hour shift myself and for recreation thought I would check my updates and this site popped up on my nhs radar! I work as a nicu nurse and (without goining into detail!) it amazing how much working in this environment makes you question the extent of health (and I take that further than sexual) promotion in the community. I deal with a number of teenage pregnancies, unwanted pregnancies, smoking/drinking in pregnancy and personally (not proffesionally) know of many people who have undergone abortion, purely for contraceptive reasons (which I have always had moral difficulty with). This sight has insipired me to look further into this subject as I feel my local area is lacking in this area. I feel that many of the situations involving unplanned children (?unloved- who are we to judge?) may be prevented, before a child( and life) is concieved. Well done! and keep up the good work!!!!!
i’m 51 and originally from Georgia…without planned parenthood (which i now am employed for over 7years) i wouldn’t know the first thing about my body because they didn’t teach that in schools whne i was going and abstinence only is preferred but lets face it…without real sex education kids are going to experiment and find out the hard way…they should have planned parenthood educators in every class by the age of 12!!!!
Have pill price complaints? Call Texas Senator Kay Bailey Hutchison at 202-224-5922, she is one of a number of Senators in a position to improve the oral contraceptive price problem. Basically, when the Deficit Reduction Act went into effect on January 1, 2007, it included provisions that had the unintended consequence of driving up pill prices for health centers like PP and other campus and nonprofit clinics. As a result, they can’t purchase a full range of pills, and have had to switch to more generics and even the prices for those have gone through the roof. They’re trying to get a legislative fix, so a call to Hutchison saying “pill prices are way too high because of the DRA — fix it now” might help.
And as for those protesters, Houston PP has a SuperHero for women’s health thing going on here http://www.pphouston.org/superhero
So glad to hear of all the people who have been helped by PP. My daughter had a probale cancer preventive surgery through them, and I am grateful.
However, I have been hearing a lot of things about other levels of PP, in particular, in third world countries where women are actually sterilized without consent. Yeah, I know… WHAT IS THIS? Well, there ARE other levels of all things we, the people, are never privy to and anyone who understands the way America and the rest of the world are run, which is again, not the way they make it look, but in truth by a small group of elite globalists, industrialists and military, then you may know what I am talking about.
But yes, I do agree that PP has been very wonderful for most women and families here in the US. It is just not the same thing every where, different people running the show, and very different agendas.
So to all the good people in PP: thank you and stay aware.
Hah! Brilliant post – Do you mind if I link to it?
Good post. Tell everyone you meet!!!
When I moved to a new city after college, before my medical coverage bagen, I made several visits to Planned Parenthood. I got the Pill, a Pap and check-up, and had a yeast infection that was resisting OTC medicine. The doctors there were comprehensive and supportive and it was a good experience overall. If it hadn’t been for Planned Parenthood … I don’t know what I would have done. (Be pregnant, with cervical cancer and thrush?)
PP is an essential service provider and needs all the support it can get.
[...] Click here for the full story: Grahamazon [...]
This post is the reason that women don’t want a male doing their pelvic exams. You’ve managed to make it this far in your life and medical career without thinking about birth control or knowing about Planned Parenthood’s services? Why would a woman be enthusiastic to have someone with this perspective responsible for her reproductive health? Most women begin thinking about these things and taking responsibility for them and informing themselves about birth control and reproductive health from their early teens.
It’d help if you went back and actually read the post, Denise.
[...] of PP services–of which only three percent are abortions, you’ll find a link to this post by a medical student, who describes his ignorance about PP until he did an OB/GYN rotation [...]
Wow, someone else has trotted out the “people use abortion for contraception” song and dance number. Anyone who knows how pregnancy works knows this is biologically impossible. Contraception keeps either fertilization or implantation, or both, from occurring. Abortion ends an already-established pregnancy, which does not occur until implantation. (Not even a fertilized egg itself is a pregnancy until it has attached itself to the uterine lining.)
So, by definition, all abortions are BIRTH CONTROL–as opposed to contraception–regardless of why they are done. It doesn’t sound good, it triggers way too many people’s Inner Nosybody, but there it is, and we might as well face it now as later.
And it doesn’t matter. If they made it mandatory tomorrow for all of us to become blood and organ donors there would be a hue and cry in this country such as we have never seen. Rightfully so: no born person is legally allowed to use our bodies for life support against our will. And this does result in people dying, even innocent people. Ask anyone who’s watched a loved one die of end-stage renal failure with no available kidney in sight for a transplant. It would be nice if we would translate this into the pregnancy situation and realize, hey, you know what? As much as most people want babies at some point in their lives, a fetus is still a guest, not entitled to stay where it is. Women still have rights over our own bodies, regardless of our pregnancy status. To say otherwise is to place a legal burden on us which no other class of human being in this country must suffer. No type of abortion should be illegal at all, and none of us should be feeling icky about someone else’s reasons for getting one. Until we stop killing people day in and day out by not being blood and organ donors, anyway, we’ve no room to talk.
(And please don’t tell me you can’t because you’re sick or whatever. Many of the folks who feel icky about abortion enough to want to outlaw it think that sick women should stay pregnant anyway–why are you special?)
And when I say “no type of abortion” I mean elective abortions. I no more think the government should be able to force a woman to get an abortion then I think it has any right to deny her one. I think that aside from regulating the various procedures on the same level as regulation of any other medical or surgical procedure, the government should be entirely hands-off in this matter. I don’t think the cutoff point should be viability but the point at which the woman would suffer greater health risk in aborting than she would in giving birth, and that’s going to vary from woman to woman and case to case.
But again, at bottom this is really about women having the right to make our own decisions for our own lives. Historically we have been owned by and forced to defer to others–first our families of origin and then our husbands. Enough. It’s not like the species is in danger of dying out.
[...] My Med Body! (med student and author of the “Planned Parenthood Ain’t Abortions” post) wrote a post about his week on Labor & Delivery. A commenter said, “And [...]
[...] Mitt Romney is taking heat for a Planned Parenthood fundraiser photo from years ago. People say this doesn’t go along with his views on abortion. But as we all know, esteemed readers, Planned Parenthood probably prevents more abortions a year than it performs. [...]