Christie Vilsack: Misconceptions of women’s reproductive health


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During the past two years as executive director of the Iowa Initiative, I’ve identified three misconceptions I had about family planning and women’s reproductive health. I assume that a lot of other people have the same misconceptions.

1. I always thought of unintended pregnancy as a problem affecting teenagers, not college-age students and adult women. I’ve applauded stories about the United States lowering the birth rate among teens. I didn’t know that the rate of unintended pregnancy among 18- to 30-year-olds has remained stubbornly high and the costs are very expensive. The overall rate of unintended pregnancy among 18- to 30-year-old women in Iowa is almost 50 percent.

2. I had no idea there were three new safe birth- control methods called long-acting, reversible contraceptives that are almost 100 percent effective in preventing pregnancy for three to 12 years.

One of them is a hormonal implant, a small rod implanted in the upper arm, which you can barely feel and isn’t visible. There are also two new, improved IUDs. One is hormonal, like the implant. The other, a copper version, simply repels sperm effectively. Each method has plusses and minuses, but today couples have so many more choices to fit their lifestyles and their individual health-care concerns.

I’m of a generation for whom “the pill” was new technology. The wistful looks on the faces of women a generation older than I, who hear me speak about long-acting contraceptives, is noteworthy, because they either had no contraceptives available to them or those that were available were unreliable.

Many young women still choose birth-control pills, but they’re not protected if they don’t take them at the same time each day. The idea of a reliable method that doesn’t require remembering to carry a pill dispenser or to set a cell phone to ring when it’s time to take the pill brings peace of mind to many young adult women set on finishing an education or finding financial stability in the job market.

3. I used to think Planned Parenthood was the only family-planning provider around. I used the name Planned Parenthood in a generic way, much as I say Kleenex instead of tissue. There are three separate Planned Parenthoods in Iowa. Today, there are 14 other family planning organizations involved in Iowa Initiative research.

Many of them are starting satellite clinics in smaller places to expand access to services. I attended the opening of a satellite of Allen Women’s Health of Waterloo in Waverly, Cedar Falls, and Independence. Northeast Iowa Community Action has expanded services to New Hampton, Fayette, and Postville. In Des Moines, Visiting Nurse Services has expanded to under-served areas like Des Moines Area Community College, West Des Moines, and the North Side.

Many of these are small businesses, and most of them receiving federal Title X funding to serve low-income women. Besides contraceptive counseling, they provide a range of services, such as testing for cervical cancer and treating men and women for sexually transmitted diseases. People of all ages, ethnicities, and economic circumstances use their services on a sliding-fee scale.

Once I shed my misconceptions, I was able to have a more realistic conversation about how parents, educators, faith-based organizations, and civic organizations can help women take responsibility for managing their general health, their fertility, and planning and spacing children they and their partners decide to conceive.

Christie Vilsack is executive director of the Iowa Initiative to Reduce Unintended Pregnancies.

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