Why is this so important? Choice vs. Access

Yes this is me and my husband Charles while I was in labor with our now 2.5 year old daughter. It was one of the most exciting times of my life as well as one of the most terrifying. Overall, I had a pretty good pregnancy but Saanvi was a bit of a surprise. During a routine fertility assessment of my ovaries, my tech asked me when my last period was, to which I responded, “I don’t know”. She promptly said, “well you’re 5 weeks pregnant”. I was in total disbelief. In fact I think I said “shut up”.

During my entire pregnancy, I realized I was never really asked how I was feeling (besides my friends and family). The truth was, I was anxious, vomiting before almost every appointment. I felt scared and unsure, I had to find a new job, and outside of my family and friends I didn’t really feel supported. I built up a really strong exterior and put on a face.

So reflecting back, I realize that as a privileged woman, that there were many other, in fact, thousands of mothers, who were never asked how they were feeling and how that translated back into a healthy pregnancy. Why don’t we ask pregnant women? And what happens to the mothers who don’t get asked? Do all women have the ability to have access to just and equitable care as well as the choice and to choose what that care looks like.

I decided I wanted to dig into this further, and did a deep dive in Washington State statistics, understanding reproductive health access and maternal health access. I realized more than 75% of the numbers reported, are often times grossly under reported. Questions like drug usage, sexual abuse, partner abuse and stressors that contribute to an unhealthy pregnancy or an unhealthy baby. Washington state’s unintentional pregnancy rate is an inferred number and we aren’t quite 100% sure its accurate.

“Unintended pregnancy is an ambiguous concept that is imperfectly measured. Pregnancy intention can vary depending on when the information is requested. For example, a woman may respond differently depending on whether she has just learned of the pregnancy or just delivered a live born infant. The concept of intending or planning pregnancies may also be influenced by socioeconomic and cultural values about sexuality, relationships, and access to and use of birth control. It is important to note that an unintended pregnancy may result in a wanted birth”.

ok so great. What does this mean in the larger spectrum of reproductive justice. Women’s health is often times viewed as a “speciality”. Our access is dependent on our socio-economic factors, race, and policy. With pregnancy, a healthy mother will deliver a health baby, if born into a stable environment, has the most likely chance to succeed.

It’s time we make a switch in women’s healthcare, to understand systematic change, encourage cooperation across all service points, and ensure that women have choice AND access instead of one or the other. We have to view pregnancy as two people, one person who needs to be delivered into a healthy environment to succeed, and the other, the mother that needs to be supported through all aspects of care.