It's a polarizing time to be sure, an era when social progress seems to take two steps back for every leap forward. Few topics seem to embody this more than that of reproductive health: Even with all the key conversations we continue to have around sexual assault and #MeToo, intersectionality, and the mere discussion of formerly taboo subjects such as menstruation and contraception, there is much to be done. And because ignorance is the primary obstacle that stands in the way of universal access to reproductive health care, there's no better offense than education.
So says Emma Corbett, vice president of marketing, communications, and engagement at Planned Parenthood Mohawk Hudson. "Knowledge is power," she says. "Become a resource for your friends and family, so that when you encounter someone with questions about their health or sexuality, you are able to point them to a reliable and accurate resource like Planned Parenthood. You can also become a resource to combat misinformation when you hear it or when you see it online."
With this very strategy in mind, we asked Corbett for her state of the union on reproductive health in 2019. Below, she shares the key things to know about contraception, the fight for choice, and more.
The fight for choice marches on.
"Although safe and legal abortion has only existed in this country for about 46 years, this critical medical care will face a number of tests and challenges in 2019," says Corbett. She notes a pretty wild circumstance: Many of the people who are currently fighting to keep Roe v. Wade intact have never lived in an America without access to this crucial form of health care. "It's unfathomable and unfortunate that politics and medicine are colliding in this way," she says. This also means that complacency simply isn't an option.
Brett Kavanaugh's confirmation last fall gave the Supreme Court the fifth conservative vote it needs to potentially overturn Roe v. Wade, which would give individual states the jurisdiction to regulate (or ban) abortion as they see fit—potentially forcing millions of women to cross state lines to seek the medical attention they need, or else face criminalization. Many conservative states have attempted to pass more restrictions over the years, painting a vivid picture of what life might be like post–Roe v. Wade. In 2018, Mississippi officials passed a bill that banned abortion after just 15 weeks, even in cases of rape or incest. (This was eventually blocked by a federal judge.)
The bottom line is this: "Abortion is health care, and health care decisions belong between the patient and their doctor," says Corbett.
There are more options for contraception than ever, but we need to work on universal access.
Just the mere discussion around birth control is heartening. If our own vocal community at The/Thirty is any indication, women are talking with both their doctors and each other to seek out the method of contraception that's truly right for them and their bodies. And there are more options than ever: "With several varieties of LARCs (long-acting reversible contraceptives) such as IUDs and implants, patches, shots, hormonal pills, and a selection of condoms and barrier methods, people are able to truly choose the best personalized method for themselves," says Corbett.
But even though the menu is more extensive than ever, universal access is still lacking, especially in the face of our current political climate. Basic forms of birth control became available with no co-pay under the Affordable Care Act, but the 2016 presidential election was enough to shock this system into preventative action. Women became so concerned about potentially curtailed access that IUD implantations skyrocketed 21% in the 30 days after Trump was elected. (Since IUDs last roughly five years, doing so offered at least some peace of mind.)
While the Trump administration has yet to successfully roll back access to the pill and IUDs, the cost of more elaborate forms of birth control (as well as the freedom to choose between brands) is still left to the discretion of insurance companies. Judging by the continued effort to undermine the coverage enacted by the ACA, we can't pretend any of this will remain a guarantee.
Residual social stigmas are still problematic as well, which tells us that the onus remains on women to prevent pregnancy. "Birth control benefits all of us—even men," says Corbett. "It's so important to protect access to contraception and to work to make that access as universal as possible. Every person deserves the right to determine their own destiny, and birth control plays an important role in that."
STI rates are up, and that's something we need to discuss.
"STIs are something that about half of adults in the United States will experience by the time they're 25," says Corbett. And those rates only seem to be going up: According to the CDC, nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017. That was up 200,000 cases from 2016, which was already a record-breaking year.
The good news? Many STIs are easy to treat, and they're even easier to prevent. "The most common symptoms of STIs are no symptoms at all," she says. "Because of this, many people delay testing or don't test at all until something else becomes very wrong. It's so important to normalize the discussion around STIs and reduce the stigma that may come with the topic."
That means a few things: Namely, getting tested on a routine basis, especially before engaging in sexual activity with a new partner. You should also definitely ask said partner about their last test and be sure to use protection in the meantime. (Condoms significantly reduce the risk of transmitting those infections.)
We're still working on "breaking out of the binary."
We've made a lot of progress in recognizing that gender identity and sexual preference goes far beyond the traditional cis-straight binary, but there's still a long way to go, especially in ensuring that everyone can feel safe seeking out reproductive health care without judgment or ignorance.
"First, we need to recognize that your gender identity does not dictate your sexual behaviors and vice versa," says Corbett. "But it's critical to have a health care provider who we feel comfortable discussing these parts of our identity with because we each deserve tailored care that helps us live as our healthiest selves."
Let's talk about sex.
Because make no mistake: We can't address all the issues discussed above without first normalizing sex and reproductive health in general. "The fact is that conversations about sex can still be heavily stigmatized in many communities, which is especially problematic for people who don't have basic tools to talk about sexual relations, sexual health, and consent," says Corbett. "Breaking down stigmas starts at home with our families and should expand in schools so every student receives medically accurate comprehensive sex education. Beyond that, community organizations can work to make information about healthy relationships widely available in the areas they serve."
"Misinformation can often be political, and is perpetuated by social stigmas," she adds. "But when we’re dealing with our health care and the health care of our loved ones, we all deserve accuracy!"