• Catherine Shuttleworth

a comprehensive guide to your reproductive rights

From birth control, to abortion, to options for trans* and non-binary people, we're here to give you a cheat-sheet on how to access what you need without shame, fear, or confusion.

Illustration by Cynthia Merhej

We haven’t forgotten about Georgia, Alabama, and Ohio’s Heartbeat bills, and, one year later, we’re still feeling the effects of them across the country. Thinking about how to access contraception, abortion, and other functions of reproductive health can feel confusing, scary, and shameful— but you're heard, loved, and not alone. Here’s a cheat-sheet on how to access what you need, as well as a guide to your reproductive rights all across the US.

I’m a teenager affected by the Alabama/Georgia/Ohio/etc. Heartbeat bills. How can I access abortion safely?

The Heartbeat Bill makes abortion illegal as soon as the fetal heartbeat can be detected, which is normally detected about six weeks into the pregnancy. For those affected by the bill, it’s best to always use birth control during sex, but if you want to be certain, take a pregnancy test after you have sex. Keep in mind that pregnancy tests aren’t always accurate for those with thyroid or hormonal imbalances, so make sure to ask a doctor to do blood work if you're uncertain. But it’s important to note that, while you should always practice safe sex, it's not your fault if you get pregnant— if you discover you’re pregnant after the legal period in your state to have an abortion, it’s legal to travel to another state and have an abortion. If this is possible for you, Planned Parenthood clinics are a great option, as well as this map from the National Abortion Foundation. In Georgia, there are exceptions to the bill for sexual assault, incest, and if the mother’s life is at risk. But beware of “crisis pregnancy centers,” which are often pro-choice institutions masquerading as abortion clinics. If you can, make sure a trusted friend or family member goes with you.

I’m only a few weeks into my pregnancy. I heard there’s more than one method of abortion. What are my options?

The cost of an abortion ranges anywhere from $0-950. It depends on a few things, such as: what, if any, health insurance you have; income; where you live; the type of abortion you get; and how far along your pregnancy is. However, organizations such as Planned Parenthood offer help when it comes to paying for these services if you are struggling to cover the cost.

You have two options regarding what type of abortion you decide to get: the abortion pill or an in-clinic abortion.

First, you take a pill called mifepristone, which blocks the natural hormone progesterone, necessary for keeping the pregnancy viable; blocking it stops the pregnancy from growing. Then you take the second medicine, misoprostol, either right away or up to 48 hours later. Misoprostol causes cramping and bleeding in order to empty your uterus. If you don’t have any bleeding within 24 hours after taking the second medicine, get in touch with your nurse or doctor— they’ll give you both medicines at the health center. When and where you’ll take them depends on state laws and your health center’s policies. You can get the pill at many Planned Parenthood health centers. It can cost up to $1000 but is often less, and it varies on whether you have health insurance.

In-clinic abortion works by using suction to take a pregnancy out of your uterus. There are two types of in-clinic abortion: suction abortion is most common— it uses gentle suction to empty your uterus and is usually used until about 14-16 weeks after your last period. The Dilation and Evacuation (D&E) method, however, uses suction and medical tools to empty your uterus. D&E is usually used if it has been 16 weeks or longer since your last period.

What options do I have when looking at birth control?

For teens looking to access birth control, it can differ depending on where you live; however, most states allow teens to get birth control without their parents’ permission. However, it’s best to call your local doctor or Planned Parenthood center to find out if the rules are different in your state regarding access to birth control. Birth control can be obtained at Planned Parenthood health centers, or from your regular doctor or nurse. If you’re on a college campus, you can acquire birth control and other contraceptives without parental permission at your Campus Health clinic, who can also provide discreet STI testing.

There are several types of birth control, but the most common ones are the implant and the pill. The implant is 99% effective and is a tiny, thin rod inserted into your arm. It releases hormones into your body to prevent you from getting pregnant, and protects for up to 5 years; however, it can cost up to $1,300. The pill, on the other hand, is 91% effective; they come in a pack of once-a-day pills, with some days marked by placebo pills. The pill works by stopping sperm from joining with an egg and the hormones in the pill stop ovulation. A prescription is required for the pill and it can cost up to $50. But, again, the overall cost is dependent on your health insurance coverage, so it’s best to set up an appointment with a general doctor or gynecologist to go over the facts.

I have a history of depression and anxiety. What are my best options when it comes to birth control?

If you have a history of depression or anxiety, it’s best to look out for a method of birth control that contains little or no hormones. Examples of these types of birth control methods are the birth control implant (which is progestin-only and has no estrogen), using condoms, or getting a birth control shot, which, similar to the implant, contains no estrogen and is progestin-only. For more options of little or no hormone birth control, you can go onto Planned Parenthood’s website for more information.

I want to access STI testing. What do I do?

If you want to have an STI test, you can discreetly ask your nurse or doctor, as it isn’t always a regular part of your check-up. It may feel awkward, but doctors have seen and heard it all; remember that getting tested means taking good care of your health. If you need some ideas on how to bring it up to your nurse or doctor, you could try:

· I’ve never been tested for an STD before. Do I need to be?

· Have you ever tested me for any STDs during my check-ups?

· What STDs should I watch out for? How will I know if I need to get tested?

Your nurse or doctor will figure out what test you’ll need, so it is important to be honest with them when they ask you questions, in order to get the best care for you. If you find out you have an STD, it is best to follow your doctor’s advice on how to treat it, and it's also important to tell anyone you’re having sex with, so they can get tested and treated. It might be hard for you to talk about it with your partner, but Planned Parenthood offers advice on how to start the conversation.

I don’t have health insurance. How do I access an abortion, STI testing, or contraceptives? Are there any funds or grants available to me?

Planned Parenthood health centres offer services regardless of whether or not you have health insurance; if you do not have health insurance, Planned Parenthood will offer you services at discounted rates. Planned Parenthood used to be protected under the federal program Title X, which means the government provides money to family planning clinics (such as Planned Parenthood) so that people who do not have health insurance can get care at a reduced rate, or, in some cases, for free. But, in August of 2019, the Trump administration forced clinics participating in Title X to withdraw from the program— but Planned Parenthood still offers services at a low-cost rate, and you can support Planned Parenthood's stance to protect Title X here.

I was AFAB, and need safe access to abortion, contraceptives, and/or STI testing as a trans* and/or non-binary person.

It’s important you find a healthcare professional you are comfortable with, who is sensitive to trans* issues as well as informed about the healthcare needs of transgender people. We recommend Planned Parenthood health centers, as they offer safe STD testing, birth control, physical exams, referrals, and other sexual and reproductive health services to trans*/non-binary people.

But we still have a lot of questions left unanswered.

According to the U.S. Department of Health and Human Services, people who received prenatal care throughout their pregnancy are, in general, more likely to deliver healthy babies. But what happens to those who can’t afford it? After all, the argument on whether health care is a right or a privilege is one that America has failed to answer for years.

The Committee on Economic, Social and Cultural Rights and the Committee on the Elimination of Discrimination against Women (CEDAW) have both indicated that women’s right to health includes their sexual and reproductive health. So, despite the obligations of the US, to respect, protect and fulfill rights related to people’s sexual and reproductive health, violations of these rights are frequent. Research shows that these violations are often a result of patriarchal concepts engrained in society, where women are mainly valued on their ability to reproduce. This begs the question: are effective reproductive rights only going to emerge as a result of a good education?

In fact, fewer young people are reporting receiving any formal sex education at all. A study conducted by the Guttmacher Institute found that fewer teens are being taught essential information about a range of sex education topics.

Just last month, on the 23rd of January 2020, the Trump administration allowed Texas federal Medicaid funding to administer a family planning program that discriminates against reproductive health care providers. This request was previously rejected by the Obama administration in 2011 as the proposal violated Medicaid’s requirement that people covered by Medicaid are entitled to obtain family planning services from their choice of qualified provider – a violation of a person’s choice to decide how they have a family.

Another example of people's reproductive rights being denied is the argument of whether the general body politic should have the right to an abortion. Despite Roe v. Wade’s continuing precedent, state legislative and executive bodies nonetheless continue to battle over access to abortion. Public funding for abortion remains a contested issue in many states, and only 17 states provide public funding to abortion services. Research has also found that only 38% of women live in counties with an abortion provider.

America mainly sees reproductive and contraception services as a privilege, not as a right. Those who have these services are lucky enough to be in a position to access them, and if you can’t access them, your life could be at stake. Lower-income people are far less likely to have access to contraceptive service; the Guttmacher Institute found that the average cost of a year’s supply of birth control pills is the equivalent of 51 hours of work for a woman making the federal minimum wage. Native American women find emergency contraception particularly difficult to access, and research finds pregnant women of color less likely to receive prenatal care compared to white women.

It’s clear there’s still a long way to go. We need to work on ensuring equal, safe and effective access for everyone when it comes to services such as contraception, family planning, and abortion. We need to make sure education is improved when looking at sexual health, focusing on abortion, relationships, pregnancy, and STI prevention. We need to recognize that a person’s right to life, liberty and the pursuit of happiness includes their right to choose what they do with their body, and allows them access to any services they may require.

Catherine Shuttleworth is a sixteen-year-old journalist from London.  Her work has appeared in Blogosphere Magazine, YR Media and Gurls Talk.  She has a passionate interest in politics and sociology and uses her platform to spread awareness and educate her readers.  In her free time, she likes to do yoga, play guitar, and binge-watch shows like The West Wing, Sex Education, and The Office.  You can keep up to date with her work and life on her Instagram: @catherineros.e.



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