A few years ago, I saw Juana (name changed), a 16-year-old girl, for her annual school physical at the free clinic where I see patients. It was unclear to me why, but she had been repeatedly denied Medicaid or any form of government insurance for the past several years, and her mom had stopped applying.
I asked Juana’s mom to leave the room so we could discuss her home life, school life, relationships, sex, and other topics best discussed without a parent. She told me that everything was good, she had a boyfriend but they weren’t having any type of sex, she was excited for her junior year of high school, and wanted to a be nurse. I told her she could come back at any time to talk about sex, or school, or life, and that I could keep that information just between the two of us.
A few weeks later, Juana showed up to clinic after school. This time she told me that she and her boyfriend had been having sex for the past few months.
They usually used condoms, but last night they hadn’t, and she needed emergency contraception. Juana said she had $25 in her pocket and wanted to make sure that would be enough to buy the pills. I set the medical student with me out to call all the pharmacies in the area. After five or six calls and an increasingly desperate plea, a pharmacist agreed to sell Juana the emergency contraception for $25. A sigh of relief. I gave her some quick information about contraception and scheduled her to come back next week to talk more. That night, I called Juana and she told me she’d successfully gotten the emergency contraception.
The next week, Juana decided she wanted a hormonal IUD. She wanted something effective that she wouldn’t have to worry about. She wanted to have a shot at nursing school. Because Juana was uninsured, I needed to fill out patient assistance paperwork so she could get the IUD device for free, and I needed her mom’s tax information in order to complete the forms.
Luckily, Juana and her mom are close and she was able to tell her mom that she wanted (or needed, you might say) an IUD. Juana’s mom works long days and it took a few weeks, but she eventually made it into clinic before our closing time at 5 pm and we filled out the patient assistance paperwork. In another two weeks, Juana’s IUD finally arrived in the mail at my clinic.
Juana is the type of teenager who cried and required handholding and deep breathing exercises with me and two nurses when we gave her the HPV vaccines. It was clear how important the IUD was to her because, for the insertion procedure, she just squinted her eyes closed and tightly held the medical students hand. This was going to happen for her.
Juana was lucky. She had somewhere to come to get help navigating the system. She had someone to advocate for affordable emergency contraception. She had someone who knew how to get a free IUD for her and called her mom weekly until she was able to come in to complete the paperwork. She has a mom who is supportive and realistic about what is best for her daughter.
It shouldn’t be this complicated to get birth control. It shouldn’t be this complicated to have a shot at the future you’ve always imagined. A vote for Kavanaugh is a vote against the rights of the young women of this country, against my patients, against doctors like me, looking only to fulfill their duty to the patients who trust them.
