As two obstetrician-gynecologists, we provide full spectrum reproductive health care — including abortion. Although COVID-19 poses an unprecedented stress on our lives and to our health care system, family planning is an essential health care service.
For our patients, the importance of family planning services in the time of a pandemic is clear. Families are grappling with unexpected financial instability, modified employment and child care routines — all against a backdrop of heightened anxiety related to their health and safety. Barriers to contraception, real or perceived, will increase unplanned pregnancy. Economic and social burdens will lead some to reconsider their ability to continue a pregnancy — like Jenna and Alex, who recently made the difficult decision to have an abortion after both losing their jobs and realizing that this was not right the time to expand their family.
Uncertainty in the health care system causes misperceptions about available care and options, as we saw with Lauren whose abortion was delayed nearly four weeks as she assumed there was no appointment availability, adding complexity and cost to her care. The consequences of waiting can have serious and long-lasting ramifications for patients and their families, as delays like this will make abortion completely inaccessible to some.
Stories like this need not — and must not — be commonplace. We cannot let a pandemic threaten reproductive rights and health. Oregon is a national leader in ensuring access to reproductive health care for all Oregonians, and is committed to providing essential health care services, even in the midst of a pandemic. The Reproductive Health Equity Act (RHEA), signed into law by Gov. Kate Brown in 2017, guarantees coverage for reproductive health services like contraception and abortion — regardless of job status, immigration status or gender identity. RHEA requires insurance plans to cover abortion without out-of-pocket costs. In Oregon, pharmacists can prescribe contraception without a clinic visit first. Tele-medicine consultations are available to discuss pregnancy options and birth control, and tele-abortion services are available. Medication abortion can be performed safely in one's home, with virtual support from a provider.
While some states are attempting to roll back reproductive rights or use COVID-19 to restrict abortion access, the opposite is true in Oregon. Oregon has multiple safeguards in place to protect and promote reproductive health. COVID-19 represents a loss of control for many people, but in Oregon we can take some of that control back by asserting our right to timely and just reproductive care.
Dr. Jessica Reid and Dr. Shaalini Ramanadhan are family planning fellows within the Oregon Health & Science University Department of Obstetrics and Gynecology.
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