Christopher Estes, MD, MPH, does not tolerate misinformation about reproductive health care. “Whenever I hear a conversation about contraception or abortion, I work my way into it to be sure that the truth is heard.”
Dr. Estes has many chances to step in, both in English and Spanish. He is an ob-gyn who practices at two Miami hospitals and teaches at University of Miami’s medical school. He has taken on myths like “IUDs and abortions make you sterile, birth control pills cause cancer, and women who have abortions are stupid, irresponsible, selfish, or all three.”
He does not get tired of challenging these misconceptions, whether in casual conversation, grand rounds, or a staff meeting. Dr. Estes wants to make reproductive health care as accessible as possible to as many people as possible. He is open about the fact that he provides elective abortions at one of the two hospitals where he practices (the other institution allows the procedure only when the woman’s physical or mental health is threatened or the fetus is at risk for abnormality). “I let people know what I do, wherever I go.”
Dr. Estes says he owes his ability to communicate effectively about reproductive health to his year with PRCH’s Leadership Training Initiative (which has since grown into the Leadership Training Academy). In the 2006-2007 academic year, Dr. Estes and five other family planning fellows learned how to advocate for reproductive health through political activism, medical education, and the media.
While training with PRCH, Dr. Estes gained skills that he relies on every day. “I learned to develop ways to talk about my work that are more in depth and deliver a cohesive message.” Before working with PRCH, Dr. Estes had never done any activism. Now he says, “I can’t imagine not doing it.” As part of the PRCH training, Dr. Estes and the other fellows went to Washington, DC, to visit their senators and representatives. This was his first experience in representing his patients’ needs to policy makers.
Dr. Estes was hooked. “It was a major eye-opener. It was exciting to see the legislative process in action and how physicians could become involved in the opinions of the people who actually write the laws in our country.”
Since then, he has joined Planned Parenthood on two trips to the state legislature in Tallahassee. He is helping to promote the Healthy Teens Act, a comprehensive sex education bill, and the Prevention First Act, which would improve education about and access to emergency contraception. Although neither bill has progressed much yet, Dr. Estes says, “We’ve garnered a good bit of support, and we’ll keep trying.”
Recently, Dr. Estes has also been calling and emailing his senators and representative on the national level to promote health care reform that includes reproductive health care. “Our biggest problem in Florida is access: people don’t have insurance. Even when you’re poor, you have to be really, really poor to get Medicaid.”
Dr. Estes notes that Medicaid is not adequate for many of the women he sees, since the Hyde amendment prohibits Medicaid from covering abortion except in cases of rape, incest, or life endangerment. Florida, like 33 other states, does not allow state Medicaid to pay for abortion. He has let his senators and representative in Washington know how Hyde hurts his patients.
In South Florida, Dr. Estes’s public advocacy is rare among abortion providers. He is determined to reverse that trend, in part by bringing interested medical students with him to Tallahassee. In his classes, he encourages students to engage fully in what they are learning from him and his colleagues. “I want students to be unafraid of speaking their minds and challenging their ‘elders.’ I tell them that speaking their minds is a good thing, and only through public discourse are we ever going to deepen our understanding of human problems—whatever the problem might be.”
While teaching and seeing patients at two hospitals, Dr. Estes conducts research on the metabolic effects of hormonal contraception and is a submissions reviewer for Contraception and three other journals. He still makes time for advocacy. “I know it’s trite,” he says, “but if not me, who will speak up? If not now, when?”