Today is World Contraception Day. In honor of #WCD2017, we are sharing the following story from one of our Leadership Training Academy alumni, Dr. Rachna Vanjani from California. Even though she’s practicing in a state with reproductive health policies much less restrictive than other states around the country, Dr. Vanjani still sees patients every day who have to fight for the health care they need and deserve.

This story sheds light on the barriers women have to go through to control their own bodies…

My patient, who I’ll call Rachel, gave birth to children in 1993 and 1996 and felt she was done with childbearing. She desired a tubal ligation (sterilization procedure) but was told by her provider at the time that because she was less than 25 years old and did not have more than three children, she was not allowed to get the procedure.

Rachel took oral contraceptive pills for contraception, but got pregnant again in 2003. She asked to sign tubal ligation papers to request the procedure at the time of giving birth to her third child. She was told she had to sign the papers in the first trimester of pregnancy and had missed the deadline.

Rachel then became pregnant for a fourth time when her third child was eight months old. She cried and felt overwhelmed, but had the fourth child. She signed the tubal ligation papers at the beginning of pregnancy to avoid what had happened with her previous pregnancy.

At the time of delivery, Rachel was told that the hospital had LOST the tubal ligation papers and she would not be able to get the tubal ligation.

Soon after, Rachel divorced and found a new partner who desired a child, despite her feeling she was done with childbearing. She conceded and had a fifth child, which resulted in a cesarean section.

Rachel then had an ectopic pregnancy (a pregnancy that occurs in the fallopian tubes) requiring a removal of one fallopian tube. She requested her other tube be removed at the time of surgery, but was unable to have this done since she did not sign the state consent 30 days prior.

She has since had two miscarriages.

That is when Rachel came to see me at my clinic. She was very happy to learn about the Mirena IUD—she had never heard of it prior to our visit. She was especially happy that it is as effective as a tubal ligation and does not require an abdominal surgery. She plans to use it through menopause (understanding that Mirena must be replaced every 7 years).