#21: How the Hyde Amendment Harms Women
Katie Breen
 |  
November 2, 2017

Katie interviews Morgan Hopkins, National Field Manager of All* Above All, a reproductive justice campaign dedicated to lifting bans that deny abortion coverage - so that every woman can get affordable, safe abortion care when she needs it, regardless of her income. Since the passage of the Hyde Amendment in 1976, Congress has withheld coverage for abortion services from women insured through Medicaid ​and other government insurance ​program​s​. Currently, this impacts nearly 29 million women of reproductive age. 

Katie and Morgan discuss the history of the Hyde Amendment, how the Hyde Amendment hurts women, what the reproductive justice movement is all about, and the simple steps you can take to help end Hyde. 

Sad Teaser Facts:

- Restricting Medicaid coverage of abortion forces one in four women to carry an unwanted pregnancy to term. 

- A woman who wants to get an abortion but is denied is three times more likely to fall into poverty than those who can get an abortion.

Inspired to take action? Check out All* Above All's resources for impact!

 

#20: How Systemic Thinking Can Change Our World
Katie Breen
 |  
November 2, 2017

Katie interviews Nilima Achwal, a leader in systemic thinking for social change. They discuss what the social enterprise sector is getting wrong, how social media and cultural phenomena like #MeToo play a role in changing the world, and how "systemic change" thinking can be applied to create large-scale, transformative social change. In the discussion, Nilima describes the cultural impetus behind her founding of Iesha Learning, the first comprehensive gender and sexuality education program in India. The program, which reached 15,000 classrooms across India, sought to address taboos surrounding gender, menstruation, and sex. Nilima explains the incredible impact of the program, and why the approach of Iesha Learning ultimately did not go far enough to create broad change in the context of gender in India. She provides recommendations for how cultural change initiatives should be undertaken, and some encouragement for those of us feeling weary about the state of our world today. 

To learn more about Nilima's work, visit her website at nilimaachwal.com.

Femtastic can be heard via the SoundCloud player above or on Apple Podcasts, Overcast, or wherever else you find podcasts!

The Case for 12-Month Birth Control Prescriptions
Katie Breen
 |  
November 2, 2017

About 43 million American women are at risk of unintended pregnancy. Of them, 12.4 million use birth control pills, patches, or vaginal rings - all hormonal, prescription methods which generally require monthly patient refill, and are reliant on the user’s continuous use from month to month in order to avoid risk of unintended pregnancy.

However, women face huge obstacles to continuation of contraceptive methods in order to avoid unintended pregnancy. In particular, there is a high monthly burden of time, cost, and energy expenditures required of women in order to refill and pick up these prescriptions month after month - especially for women who work hourly-wage jobs, do not have access to reliable transportation, live in rural areas, or already have children. It is clear that providing women a longer supply of their contraceptive methods leads to greater continuation of the methods, fewer unintended pregnancies, and less cost per client - outcomes that are positive for women, healthcare professionals, and health insurance companies alike.

Giving women access to extended supplies of contraceptives can addressed through a two-pronged approach: state or federal policies that allow for prescriptions of one-year supplies of birth control, coupled with thorough education for providers on this policy change.

Women who receive a one-year supply of their preferred method of birth control have been found to be 30% less likely to experience unintended pregnancy compared to women receiving a one to three-month supply. However, dispensing patterns currently vary by state and insurer, with most insurance plans limiting prescriptions to one or three-month periods, and most states doing nothing to change this. While laws requiring insurer coverage for 12 month-supplies of oral contraceptives have been enacted in twelve states and the District  of Columbia since 2015, some states have experienced a lack of utilization of these new policies due to lack of provider awareness of the laws.

In the case of Oregon’s 2015 roll-out of this policy, for example, many healthcare providers, pharmacists, and health insurance companies were unaware of the new law or did not have time to update their internal technology systems to allow automatic approval of 12-month birth control prescriptions; in the case of one insurance company, it took 11 months from the time the law took effect in January 2015 to update their systems to prevent disapprovals for these prescriptions.  And of course, certain insurance plans were exempt from the law, including federal insurance plans like Tricare and Oregon Health Plan, whose client base of low-income women is arguably the demographic group most likely to benefit from this policy. According to Oregon Public Broadcasting, Oregon’s Department of Consumer and Business Services received so many complaints in 2016 that it issued a bulletin, a full year after the law went into effect, to remind insurers of their obligations and the penalties for lack of compliance under the Oregon Insurance Code.  

It was suggested to Oregonian women seeking these prescriptions that they may need to educate their providers, pharmacists, and insurance companies about the law. This is hardly a solution, particularly given that this law was specifically designed to reduce the burden on women of receiving their contraceptive prescriptions. Passing policies that allow for 12-month supplies of contraceptives is the first step towards addressing the public health problem generated by allowing for only short-term supplies of contraceptives; however, these policies are ineffective without ensuring thorough education for providers, pharmacists, and insurance companies on their benefits.

Some states have enacted solutions outside of 12-month prescriptions to expand contraceptive access, including allowing birth control to be sold over the counter, or allowing patients to obtain prescriptions from pharmacists, online services, or smartphone applications without first requiring an in-person visit to a physician. However, each of these solutions has run into complications in practice, ranging from minimum age requirements for prescriptions, limits on the type of contraceptives that pharmacists can prescribe, and if the patient needs a prior visit to or prescription from a physician.  While policies that allow for 12-month supplies of birth control have also proven to be imperfect, they are, in my opinion, the simplest route to ensuring continuation of contraceptive method.

References:

Foster, D., Hulett, D., Bradsberry, M., Darney, P. and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, [online] 117(3), pp.566-572. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21343759 

Guttmacher Institute. (2017). Contraceptive Use in the United States. [online] Available at: https://www.guttmacher.org/fact-sheet/contraceptive-use-united-states

Guttmacher Institute. (2017). Moving Oral Contraceptives to Over-the-Counter Status: Policy Versus Politics. [online] Available at: https://www.guttmacher.org/gpr/2015/11/moving-oral-contraceptives-over-counter-status-policy-versus-politics 

Lehman (2017). Insurers To Get Reminder About Oregon's Prescription Birth Control Law. [online] Opb.org. Available at: http://www.opb.org/news/article/oregon-prescription-birth-control-law-insurers-reminders/ 

Portland Monthly. (2017). Are Oregon’s New Birth Control Laws Actually Helping Anyone?. [online] Available at: https://www.pdxmonthly.com/articles/2017/1/4/are-oregons-new-birth-control-laws-actually-helping-anyone

PPAoregon.org. (2017). Did You Know That Oregon Law Guarantees a Full Year of Birth Control? | Planned Parenthood Advocates of Oregon. [online] Available at: https://www.ppaoregon.org/2017/06/05/did-you-know-oregon-law-guarantees-full-year-birth/

Steenland, M., Rodriguez, M., Marchbanks, P. and Curtis, K. (2013). How does the number of oral contraceptive pill packs dispensed or prescribed affect continuation and other measures of consistent and correct use? A systematic review. Contraception, [online] 87(5), pp.605-610. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23040121

The Henry J. Kaiser Family Foundation. (2017). Oral Contraceptive Pills. [online] Available at: https://www.kff.org/womens-health-policy/fact-sheet/oral-contraceptive-pills/ 

#19: When Family Planning Means Sterilization
Katie Breen
 |  
November 2, 2017

Katie interviews Zoe Hamilton, a researcher and expert on India’s family planning policies, about the country’s complex relationship with female sterilization and reproductive justice. Zoe and co-director Anne Munger are working in Mumbai on a feature-length documentary called Sterilized, which examines the Indian government's use of sterilization as a means of family planning and population control. In the interview, Katie and Zoe discuss how India's controversial family planning policies affect the lives of women. They examine the political forces - in India and in our own countries - that lead women to have tenuous control over their bodies and choices.

The trailer for the film can be viewed here. For updates on the film, follow Zoe and Anne's production company, Goat Tree Productions, on Instagram, Facebook, and Twitter.

Femtastic can be found on iTunesOvercast, and SoundCloud, or wherever else fine podcasts are found. Check us out on FacebookTwitter, and Instagram for updates, great content, and the occasional funny meme. And please don't forget to subscribe and leave a review on iTunes/Apple Podcasts! Reviews are the #1 way for more people to discover the podcast.

#18: HAHAS FOR TATAS - BREAST CANCER AT 31
Katie Breen
 |  
November 2, 2017

If you never imagined an interview about cancer could be funny, you haven't met Elissa Banker. Elissa is a 33-year-old breast cancer survivor and founder of Polite Tumor, an organization that supports young women by alleviating some of the financial impact of breast cancer. Katie and Elissa discuss what it's like to be diagnosed with breast cancer at 31, the unique considerations that women diagnosed under 40 face (such as how to deal with potential infertility), how treatment can impact your sex life and body image (spoiler alert: we're talking about bloat, boobs, and "dry vag," in Elissa's words), the financial impact of cancer, and how to support a loved one going through treatment.

Live in the Denver area and want to support Elissa's work? Join Polite Tumor for an evening of laughs on October 22. More info here!

Femtastic can be found on iTunesOvercast, and SoundCloud (the SoundCloud app works great for Android-users too)!

Follow on FacebookTwitter, and Instagram for updates, great content, and the occasional funny meme - and share with your friends!

And please don't forget to subscribe and leave a review on iTunes! Reviews are the #1 way that more people will be able to discover the podcast.

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