Providing Women of All Backgrounds Adequate Sexual Health Care
Access to sexual health and contraceptive services is extremely inequitable in the US, largely due to socioeconomic differences that divide the country. One 2016 New England Journal of Medicine study found a strong association between income and education and rate of unintended pregnancy in the United States. Latina women, as a group, have lower incomes and educational levels than white women, and thus have more unintended pregnancies and fewer abortions than their white counterparts. However, the study found that Latinas had a higher rate of unintended pregnancies than white women even after accounting for income. This is likely attributable to cultural differences that transcend economic boundaries.
Nonetheless, the study presents optimistic news. After decades of little change, unintended pregnancy rates declined substantially for all women in the United States from 51 percent to 45 percent in the short time span of 2008 to 2011. The largest change among racial and ethnic groups was seen for Latinas, with a decline of 26 percent in just those three years (a massive change compared to 13 percent for whites and 15 percent for blacks). The study suggests that the substantial drop, especially for minorities with a lower average socioeconomic status, is likely due to increasing free access to highly effective contraceptives, particularly intrauterine devices (IUDs).
This increase to free access for low income individuals is largely a result of the creation of incredible non-profit organizations providing women’s health services. Puentes de Salud is one of these non-profits. Located in Philadelphia, Puentes was founded in 2003 to provide healthcare to the vulnerable population of undocumented Latino immigrants. Dacey Stratton, medical director at Puentes, joined the organization in 2016 and established their women’s health services. She believes deeply in every woman’s right to contraceptives, and thus created the program with a focus on expanding access to sexual health and contraceptive services.
Stratton works with providers to give free access to all of her patients seeking contraceptives. Overcoming this substantial financial barrier, she continues to explore other ways to improve the efficiency of the clinic’s services. Stratton noted waiting time for contraceptives, specifically IUDs, as another important obstacle affecting patients. Several of her own patients at a previous clinic became pregnant in the several months that they had to wait for IUDs. In addition, Stratton noted the language barrier for many of her Latina patients as a contributing factor to unintended pregnancies. Despite an increasing number of sources dismissing long held myths about periods and pregnancies, as well as advertisements for effective contraceptives, such information is often only available in English. This creates a “knowledge gap” surrounding women’s health and contraceptive options.
Stratton addresses these obstacles by providing in-depth explanations of basic bodily processes and contraceptive options in Spanish with the use of 3D diagrams and charts. She extends her appointments to 30 minutes (twice the time she has been allotted in past clinics) so that she can answer all questions and provide a full list of options to each patient. Stratton notes that education levels vary drastically among patients and hence she “adjusts the amount of information given to fit the capabilities of the patient,” but never gets rid of important knowledge. For example, she makes sure to list full benefits and efficacy levels of each contraceptive option. Furthermore, Stratton provides patients with their preferred method of contraceptives the same day, if possible, and takes no more than a few weeks at the latest.
The extended and comprehensive women’s health care provided by Stratton and her team at Puentes gives women the ability to make effective, independent, and well-informed choices about caring for their health and well-being. Stratton explains that the organization “bends over backwards to make healthcare easy.”
Unplanned pregnancies still made up almost half of all pregnancies of Latinas in 2011. But the future looks bright. The women’s health services at Puentes de Salud, among other impactful clinics nationwide, will likely lead the way towards a future where Latinas and women of all backgrounds are provided access to the sexual health services they deserve.
To learn more about Puentes de Salud and their impact, as well as provide support in any form possible, visit their website.
Written by Catalina Ruiz. Originally published in La Vida Magazine, the only Latinx-interest publication in the Ivy League.