Battles Over Birth Control in Missouri Foreshadow a Post-Roe World

Rolla, Missouri — For more than half a century, the Tri-Rivers Family Planning has been running on a small budget, primarily for low-income female customers with contraceptives, pregnancy tests, sexually transmitted disease treatments, and other reproductive medicine. It offers. Ozark Mountains.

The clinic has never had an abortion. But the job is more important than ever, as the Supreme Court is widely expected to revoke the constitutional rights of abortion established in the Roe v. Wade case, and nurse practitioners and patients are more threatening than ever. I have never felt.

Last year, the Republican-led Missouri Senate announced that with an intrauterine device, two common ways to prevent pregnancy. Emergency contraception — The so-called morning after pill, also known as Plan B — many anti-abortion opponents call this “abortionThis is because it can prevent the fertilized egg from being transplanted into the female uterus. Legislators later abandoned their efforts, but some lawmakers said if Roe collapsed. They may try again..

“Attack is unforgiving. We can chop up what we’re doing. They’re doing it,” said the clinic’s manager, who has worked for Tri-Rivers for 30 years. Lisa Ecsi Davis said. “It’s exhausted.”

The end of Roe will make the need for effective contraception more urgent than ever. But even now, nearly 60 years after the Supreme Court guaranteed the right to use contraception, and more than 10 years after health insurance reforms required private insurance companies to apply contraception, many American women still I’m having a hard time accessing contraception.

Funding for TitleX, a federal safetynet program that helps fund family planning clinics like Tri-Rivers, has been flat for over a decade.Private insurance company Not always covered All costs of contraception despite ACA requirements. 6 states Allow pharmacists to refuse Prescribing contraceptives for religious or moral reasons without taking steps to help the patient prescribe contraceptives elsewhere.

“This is our daily life,” lamented Rachel Goss, managing director of the Iowa Family Planning Council, which manages the Title X grant in Iowa. “You are fighting this constant and difficult battle just to provide safe and legal care for now.”

Parliamentary Democrats, who are aware of strong political issues in the upcoming midterm elections, are pushing for greater access to contraception.

Last week, they introduced a law requiring insurance companies to fully cover all FDA-approved contraceptives, including emergency contraceptives.

But some Republicans on the far right are widespread Restrict access To Emergency contraceptionTaken within a few days of unprotected sex will prevent pregnancy.

Elizabeth Nash, a national policy expert at the Guttmacher Institute, a research group that supports the right to abortion, said: When anti-abortionists persuaded legislators to define pregnancy as starting with fertilization, she said, “being able to provide contraceptive care can cause complications.”

Texas already State family planning program From emergency contraception payments. Missouri is one of 13 states with a “trigger law” that immediately bans abortion if Rho overthrows, and is becoming another frontier in the battle for contraception, in the post-Raw world. You may foresee what will happen.

In February, it became the fourth state after Arkansas, Mississippi, and Texas, and excluded Planned Parenthood, the leading provider of contraception nationwide, from its Medicaid program.The planned parent-child relationship is Asked the Biden administration to interveneSaid that the move violated federal law. A spokesman for the Federal Center for Medicare and Medicaid Services said government agencies were “considering policy options within their authority.”

In the meantime, Medicaid patients have to be treated elsewhere and often take a long time to wait for an appointment, Missouri, a non-profit organization that manages Title X grants in the state. Michelle Torpiano, Managing Director of the Family Health Council, said.

In Laura, a small city of about 20,000 people along historic Route 66, Tririvers Chief Nurse Practitioner Haley Kramer reveals that contraception is a very personal decision for her patients. I said that I am doing it.

24-year-old Kaitlyn Ball became pregnant while taking oral contraceptives and is now 3 years old. She doesn’t want to get pregnant again.She got an IUD after she consulted with Mr. Kramer

Taylor Gresham, a 25-year-old dancer, has been a patient with the Tri-Rivers since she discovered she was pregnant in the summer before her third year of high school. After she had an abortion, the clinic provided her with Depot Provera. Her mother said, “High school students probably won’t take medicine every day,” she said, and thought it was a good idea.

After she graduated, Gresham chose the IUD. More recently, she has begun taking oral contraceptives again. “I have a better daily life in my life,” she explained.

In 1965, in the case of providing Roe with a legal blueprint, the Supreme Court declared that the couple had a constitutional right to use contraception. The ruling in the proceedings, Griswold v. Connecticut, established the right to privacy that the court implied, even if not depicted in the “penumbra” of the Constitution. This is the same rationale raised in Law eight years later.

Griswold put contraception at the forefront of national conversation at a time when policy makers focused on eradicating poverty. In 1969, President Richard M. Nixon declared that “American women should not be denied access to family planning support because of financial conditions.” Title X was established by Congress the following year to help so-called family planning clinics pay for the care they provide to low-income patients who are charged based on family size and income.

Old newspaper clippings were made by the mayor of Rolla when Tri-Rivers (originally an affiliate of Planned Parenthood) was founded in 1971 and more than 100 Rolla merchants made donations to run the clinic. It indicates that you have come to the ribbon cut.

Last year, Tri-Rivers treated more than 1,800 patients, more than half of whom were uninsured. The clinic will receive $ 250,000 for the title X $, just under half of its annual budget. This “has remained the same for many years,” said Toni Stubblefield, President and Chief Executive Officer.

Located between St. Louis and Springfield, the clinic, which serves approximately 10 county areas, once had two satellites. One was closed a few years ago and the other was a victim of tight budgets and Covid-19 last year.

Some Tri-Rivers patients need to drive 3 hours round trip to be seen. This is a challenge to ensure that some women, especially those who work or have young children, are completely invisible.

Decision-making power, reproductive rights advocacy group, Estimated by over 19 million American women I live in a “contraceptive desert” which is defined as “a county without reasonable access to a health center that offers the full range of contraceptive methods”.

The year Donald J. Trump was president has caused some of the greatest hardships ever for a family planning clinic. The Trump administration’s “Gag Rule” has banned title X grant recipients from referrals to patients for abortion. Ecsi Davis posted a sign on the wall of the Tri-Rivers about a rule that is a less veiled critique.

“I always felt wrong about not being able to provide people with the information they were looking for,” said nurse practitioner Kramer.

Then, in 2021, the Missouri Senate voted to ban Medicaid funding for Plan B and the IUD.

“I am a devout Catholic and believe that life is sacred from the moment of conception to the actual death,” said Republican Senator Paul Wieland, who led the effort. For those that kill human lives. “

language It urged a turmoil from a female parliamentarian.Governor Special legislative sessionAnd it Rewritten Prohibiting public funds from the payment of “abortion drugs or devices used to induce abortion”.

National leaders of the anti-abortion movement say their next impetus is to ban drug abortion, the two-tablet regimen that ends pregnancy. Contraception “is not something that catches our eye,” said Kristan Hawkins, president of the Students for Life of America, leader of the anti-abortion group.

However, like Wieland, Hawkins said he believed that the IUD and emergency contraceptives were “mislabeled as contraceptives.” “This is a contraceptive’scam’,” she added.

Since last month’s leak of draft opinion that will overturn Roe, some Tri-Rivers patients are looking for an intrauterine device that can stay in place for up to 7 years or stock up on emergency contraceptives. I am.

Anyone can buy Plan B at the clinic for $ 20. No prescription required. Patients say this is about half the selling price of Wal-Mart. For Medicaid patients who can’t afford it or don’t live nearby, Mr. Kramer can also write a prescription, and Medicaid will pay for it — “at least for now,” she said. ..

Still, her patient is worried. Sydney Breedlove, a 23-year-old graduate student, said she used Plan B twice and purchased it at the clinic. She said she bought it for her friend at the age of 16 when she was 19.She said some of her friends were hoarding, and some were afraid they would be forced to give up their IUD.

In the leaked draft opinion, Judge Samuel A. Arito Jr. emphasized that “our decision relates to the constitutional right to abortion and not to other rights.” Some legal experts speculate that Judge Arito is trying to send a message that the court is not trying to completely revoke the right to privacy based on both Law and Griswold.

However, some Republicans are still targeting Grizzwold. Tennessee Senator Marsha Blackburn has ruled “Constitutionally unhealthy.. Republicans run for state-wide offices Michigan When Arizona Echoing that language.

In decades of Roe v. Wade, reproductive advocates have seen blueprints to limit access to contraception. After abortion was legalized in 1973, opponents succeeded in abandoning the decision by persuading courts and state legislatures to impose new requirements such as waiting periods and the consent of minor parents. did.

“When do they start saying,’You can’t access this contraceptive or this service just because you’re a 16-year-old woman?’ “Mr. Kramer said. “I’m worried that access will be restricted.”