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Mary Fjerstad, RN, NP, MHS

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The Overlooked Realities of Reproductive Health

Posted: 01/21/2012 7:21 pm

This month marks the 39th anniversary of the passage of Roe v. Wade and an opportunity to resolve to either enhance or repeal the laws that ensure a woman's right to choose, depending on which side of the issue you support. For me, it is a time of reflection, to remember the lives of women in the U.S. and in faraway places, whose courage touched my life when they came to me for help.

I am a nurse practitioner and midwife, and I have had the privilege to meet women all over the world, from San Diego, to rural Tennessee, Guatemala and Ethiopia, whose ability to access a safe abortion and/or reproductive health care changed the course of their lives, and in many cases, saved it. I've spoken with and treated women for whom pregnancy was the most joyous moment in their lives, and others for whom pregnancy was a death sentence.

I recall a female inmate here in San Diego who sobered up and detoxed while in a jail cell -- only to realize she was pregnant. The look in her eyes was desperate. She did not want to bring a child into the world under these circumstances. I recall a woman who already had a young daughter with severe birth defects, unable to eat or breathe on her own. The woman became pregnant again when her birth control failed. Upon learning that she was pregnant, her husband left the family. She came to me with the same desperate look in her eyes, facing an unimaginable dilemma -- to continue to care for the gravely ill child she already had -- or to let her die and have a healthy baby. Having both was not a possibility. Both of these women had a unique set of circumstances -- ones that led to a carefully considered decision not to have a baby. At a different time of their lives, they may have made an entirely different choice. This is an often overlooked reality about what it is to be a woman -- the same woman at age 25 makes different reproductive health and childbearing choices than she does at age 40. And no one should stand in her way when she tries to do so.

I have seen firsthand, too many times, what lack of choice and lack of health care does to women, particularly women in the developing world. I knew women in Guatemala who had such advanced tuberculosis that becoming pregnant was a death sentence for them and their babies. One woman died in the fifth month of her pregnancy. Another woman lived to deliver her baby but she was so weak, she could not breastfeed. Her only option was to give the baby unpurified water and a tiny bit of formula. Both the mother and the baby died within six months. Like many in the developing world, these women had no access to medical care. If they had received timely medical care, they would have received timely treatment. Because they were so weak and the drug regimen for TB is not recommended during pregnancy, they would have been counseled to terminate their pregnancies. What happened to them was a disaster cascade experienced by the poorest of the poor world-wide: no medical care, no contraception availability and no reproductive choices. The inherent risks of pregnancy and childbirth become a matter of life and death.

While Roe v. Wade still protects a woman's ability to access an abortion in the United States, I believe that true choice is about giving all woman access to all options to prevent, delay or terminate a pregnancy, or to have a safe delivery of a wanted baby, no matter where in the world she lives. In my current work with WomanCare Global, I'm able to help women around the world make choices about their reproductive health by providing affordable, quality products for contraception, fertility and pregnancy management. Our primary mission is to get quality products to women in developing countries where products are not always safe, accessible or affordable.

Consider this: Globally, more than 215 million women would like to be using modern methods of birth control but do not have access to those products. Every day, 1,000 women die from pregnancy related complications, and every year, more than a half a million children lose their mothers in childbirth. Access to choice for all women would prevent many of these tragedies -- unintended pregnancies would drop by more than 70 percent, and 150,000 fewer women would die in childbirth. It is heartbreaking to think of a 15-year-old girl in some parts of Africa with restrictive abortion laws who has a 1 in 22 risk that she will die as a result of pregnancy or childbirth in her lifetime. In contrast, a 15-year-old in Sweden has a 1 in 48,000 chance of dying in pregnancy or childbirth in her lifetime.

As we mark the 39th anniversary of Roe let us remember that choice is about all choices -- the choice to have a baby and when to have one, if ever at all. Protecting this choice is what Roe v. Wade is all about. And all women -- no matter where they live -- deserve that right.

 
This month marks the 39th anniversary of the passage of Roe v. Wade and an opportunity to resolve to either enhance or repeal the laws that ensure a woman's right to choose, depending on which side of...
This month marks the 39th anniversary of the passage of Roe v. Wade and an opportunity to resolve to either enhance or repeal the laws that ensure a woman's right to choose, depending on which side of...
 
 
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HUFFPOST SUPER USER
TeamSanity
strong emotions don't equate strong arguments
03:48 PM on 02/06/2012
Thank you for a fact-filled, polemic-free essay. I'm forwarding this to everyone I know.
05:26 PM on 01/30/2012
Yes, in many places of the world, people have a choice of whether or not to destroy their unborn child. Does that mean it is aceptable?

We as a society are given much to many excuses for abortion, and few are valid. Over population, haelth problems, you name it. The reality in the U.S. is that more than half of pregnant women who recievie abortions are not ready for their bodies to change, and to give up their lifestyles.

In countries where the woman, many times girl, is starving or malnourished, I can understand not wanting that for a child. Still, I do not believe that the life of something that is NOT YOU should be entirely controlled by the mother. Many women do not do it for the right reason, if there is one. Many times, the person is rightfully plagued for the rest of their lives.

In ancient rome,often the parents of a child had around 4 years to decide whether or not to keep their child. if they killed past then, it was murder. We consider that insane, but do we really understand?

Please, women, consider your options. Adoptions vary in many different forms, and do not include your infant waiting at an orphanage as many pro-choice advocates may claim. You can CHOOSE good parents. Trust me, I know first-hand!

Please read this, and think before your do something so terrible to your child. Would death really be better than their lives? Think selflessly.
09:36 AM on 01/22/2012
This is the type of thought that goes as logic when a person puts themselves above the plans of God...since the America I live in today says they don't need God, I guess then people are smarter than God and can determine when a human should be killed. Very sad.
HUFFPOST SUPER USER
dahile00
Your micro-bio is empty
08:23 PM on 01/22/2012
You apparently were very selective in your reading. She gave concrete examples of when an abortion would've saved a woman's life. Now.....Who's the one not looking at the bigger picture? Will YOU force a woman and child into a certain death sentence pregnancy?
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11:24 PM on 01/21/2012
Thank you so much for offering hypothetical situations that I had never considered. There are so many reasons why a pregnancy might be a danger to a woman's health & most people will not or can not accept that.

I have 2 adopted children and, yes, I'm *very* pro-adoption. But I would never want a woman to put her life at risk so that someone else could have a child.
10:18 PM on 01/21/2012
Great post!
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Cuyahoga
Yes I know my micro-bio is empty.
09:46 PM on 01/21/2012
In 1991 a coworker told me she was pregnant. She said "We cannot afford a 3rd child but we love our children and will love this one too." A few weeks later she was hospitalized. She had undiagnosed lupus (not diagnosed for another month or two) and because of that, the pregnancy was poisoning her. After 10 days her doctors said "You must abort or you will die." She signed the paperwork. Her husband reacted by abandoning her for two weeks.

She called me @ work and asked me to pick her up at Rose Medical Ctr (Denver) to take her home. It took 2 nurses to put my almost skeletal friend into my car. I took her to her home to await her 2 boys from school. Her husband stopped punishing her after another week and came home to let her know how disappointed he was in her for terminating the dangerous pregnancy.

Women's healthcare - women's decisions. No apologies.
01:06 AM on 01/24/2012
I'm all about a woman choosing an abortion in exchange for her own life. Got it.

No apologies for having an abortion? That's severely illogical. There are consequences for our actions and abortion is one of the worst choices a woman can make out of convenience. There is no way to justify a right out of it. Adoption is a fantastic alternative that works very well in the U.S.. Also, there are plenty of gov't driven programs aimed for mothers with kids too. Here's an idea - drop the baby off at a church - no questions no worries. Every human deserves a chance to live. Stop turning the abortion issue into a struggle for power. Pro-lifers are not about that - it's about what we value in terms of life and human decency.
09:43 PM on 01/21/2012
Yes, it's very odd that conservatives often oppose contraceptive services as well as abortion services. It makes no sense at all. But then, much of conservative philosophy makes no sense at all, as it is based mainly on false ideas and emotional responses to complex issues rather than rational approaches to problem-solving.
04:37 AM on 01/22/2012
What doesn't make sense to me is pointed out in this very article:

"The woman became pregnant again when her birth control failed."

According to the Guttmacher Institute (Planned Parenthood's own polling center): " • Fifty-four percent of women who have abortions had used a contraceptive method (usually the condom or the pill) during the month they became pregnant. "

Do you really think that an increase in the use of birth control will lower the rate of abortion? These statistics prove otherwise.
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dahile00
Your micro-bio is empty
08:27 PM on 01/22/2012
It should lower it quite a bit, honestly. And, if you're the type who thinks abortions should be banned in ALL circumstances....How about the woman with TB, hmm? How about the other life threatening complications that arise and become emergencies?
02:54 PM on 01/23/2012
Yes. If that's what you think those statistics prove, you truly need to educate yourself more about what exactly you're looking at. These statistics prove no such thing.
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thinkingwomanmillstone
My life is microbiodegradable.
08:02 PM on 01/21/2012
"While Roe v. Wade still protects a woman's ability to access an abortion in the United States, I believe that true choice is about giving all woman access to all options to prevent, delay or terminate a pregnancy, or to have a safe delivery of a wanted baby, no matter where in the world
she lives." This sentence says it all. Although Roe v Wade protects a woman's right to access an abortion in the US, it certainly doesn't protect the availability of services within the US. Access to repoductive care is being attacked at many levels...from basic services of pap tests and mammograms through contraceptive services and onto termination of pregnancies. A law that is in force is all well and good, but, if there is no reasonable access to services, it is as if it doesn't exist. Those who are against choice for women, should be putting all of their efforts into supporting contraceptive services through planned parenthood, low cost clinics and mandatory coverage in insurance plans. The best way to prevent abortion is to prevent an unwanted pregnancy.
10:09 PM on 01/21/2012
Said so well, thinkingwomanmillstone.
10:18 PM on 01/21/2012
You, my new friend, have provided an informed and thorough
commentary on he issue of Women's Rights in the US, at least
as they pertain to reproduction.

I wish that you were advising the President. For now, my
meagre fan/fave will have to do as my vote for you.
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HUFFPOST SUPER USER
thinkingwomanmillstone
My life is microbiodegradable.
10:50 PM on 01/21/2012
The illogical actions of the anti choice movement (they are not pro life in any way) are astounding and belie their stated motive...to prevent abortions and save children. What they are really interested in is making women "pay" for being sexual. If a woman is sexual and has access to birth control or abortion, how will society know that they are immoral. They also become more independent of "their menfolk". Society can no longer brand them or put them in stocks...so they will make them bear unwanted children so that "good non sexual" women can feel superior and their husbands, fathers and brothers can pretend that the good women don't want to engage in sexual activity. Of course, Men will still be exempt from any responsibility for their actions as they have been seduced by the fallen women or they have sought the services of the fallen women to spare their own women from sexual relations Discomfort with female sexuality, control and puritanical attitudes are behind the anti choice movement...not any concern for women or unborn children.