When I was in residency in California, I took care of Rita, a young Catholic mother of five. Rita was suffering from a serious heart defect.

She was six weeks pregnant and had a defective cardiac valve that needed to be replaced with a synthetic one. Pregnancy put her at high risk for blood clots forming on the new valve. The clots were traveling to her brain, where it could kill her. Rita had not been using contraception because she had no insurance to make it affordable—not because she didn’t want to use it.

While in the hospital, despite taking blood thinners to treat her clots, Rita had a stroke. The woman I had spent hours with talking about caring for her five living children, her marriage, how to handle her unplanned pregnancy—that woman could now no longer speak or walk. When I think of birth control access, I think of Rita and her family.