June 20, 2018
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Maine should strengthen reproductive health, fund bill to expand access to care

JASON REED | Reuters
JASON REED | Reuters
In this March 2014 file photo, Instructor Peta Howlett practices her moves during an International Women's Day event at a women's-only pole dancing fitness studio called Studio Exclusive.
By Michelle Shore, Special to the BDN

Recently the Maine Legislature passed LD 1247, an act to expand access to MaineCare-funded family planning services to childless adults with incomes up to 200 percent of the federal poverty level. It awaits funding.

Maine policy allows women to access publicly funded health care to cover the medical costs associated with pregnancy. Considering that nearly half of all pregnancies in Maine are unintended, and that MaineCare covers the prenatal care and birth costs from approximately two-thirds of those unintended pregnancies, these costs add up to a hefty bill.

Access to family planning services for low-income women has saved the state millions of dollars in public funds: $19.8 million funds in 2010.

Contraceptive services provided by Title X-supported family planning centers in Maine helped women under age 20 avoid 1,700 unplanned pregnancies. Without these services, the number of teen pregnancies would be 103 percent higher. Overall, services provided at the centers helped Maine women avoid 6,300 unintended pregnancies, which would have resulted in 3,100 births and 2,100 abortions, according to the Guttmacher Institute.

How many more unplanned pregnancies could be prevented by expanding access to family planning services?

For those concerned that increasing access to family planning services might somehow cause the abortion rate to grow, the Guttmacher Institute reported that without access to family planning services, the number of abortions would actually be 92 percent higher. What better way to lower the abortion rate than by preventing unplanned pregnancy in the first place?

There’s more to family planning services than access to contraception. Family planning does mean contraceptive services and supplies, true, but it’s also pap tests, tests and treatment for sexually transmitted infections, routine preventative primary services that relate to family planning services (such as breast exams, pelvic exams, etc.), education about sexual assault and pregnancy planning, and more.

And it’s not just women who benefit from access to family planning services. Men can access condoms, STI screening and treatment, sterilization and family planning education. It takes more than one person to make a baby, after all, and reproductive health goes beyond the pill.

For many people, though, just getting access to the right form of birth control can be a struggle. In my second year of college, I accompanied a nervous friend to her doctor’s appointment, where she worked with her physician to find the right birth control for her. She needed something to tightly regulate her long, painful periods, so an IUD was out, as was the Depo Provera shot. She suffered from hormonal migraines, which ruled out a number of higher-dose pills. In the end, she received a prescription that seemed to suit her needs, but our clinician still asked her to come in for a follow-up, just to make sure she wasn’t having an adverse reaction. Luckily, her insurance covered multiple visits. Another woman might not be so lucky.

Access to family planning is a particularly poignant issue for me as a young bisexual women. Despite belief to the contrary, young bisexual and lesbian women are actually at a higher risk for unplanned pregnancy than straight women — for many reasons, including choice in planned sexual partners, low income and fear of discrimination from health providers.

The high risk of unplanned pregnancy may also correlate to the high rates of sexual assault for bisexual women: Bisexual women have nearly a 50 percent likelihood of sexual assault in their lifetime. Access to family planning services is critical to allowing women to have as much choice in their reproductive health as they can.

Passing LD 1247 means ensuring that Mainers have families when they’re ready to have families. It means women being screened for breast and cervical cancer. It means access to testicular cancer screening and STI prevention and treatment. In an unstable economy, it may be the difference between living above the poverty line or dropping below it.

Maine legislators need to keep LD 1247 alive. Access to family planning isn’t a special interest issue. It matters to everyone, and Maine cannot afford to let it go.

Michelle Shore is a graduate student in the School of Social Work at the University of Maine. She received her undergraduate degree in sociology and women’s and gender studies from Brandeis University. She has interned with the Mabel Wadsworth Women’s Health Center in Bangor and the National Family Planning and Reproductive Health Association in Washington, D.C.


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