A Note About Texas

Sometimes when I write for this blog, I feel like I'm just another noise in an already massive echo chamber. I get discouraged, I feel invisible. I think to myself, 'maybe it's okay to be invisible, maybe you shouldn't have a voice in this.'

I've been writing since I was ten, and as a junior I started a magazine at my high school called The Voice. But I've always been shy about my writing; my poems are all small, crammed into tiny spaces as if someone was going to come and take up the rest of the page. My first chapbook was called Shy Knees. I rarely share my writing with other people, I rarely reach out to publications to ask them if I can write for them. I rarely even post on this blog. Some of it stems from fear. I don't want people to think I'm a bad writer. I don't want to read the mean and cruel comments that can sometimes follow the bottom of a post. I don't want to talk about myself. As a white-presenting middle-class woman living in San Francisco, I'm sometimes the last person in the world who needs to have an opinion on something. It's better for me to step aside and let other people have the floor.

I think, too, it's hard to tell when writing has impact. I've always loved to-do lists and I still have a bucket list I wrote over ten years ago that includes the missive "change someone's life." I wonder if I've ever done that with my writing. I wonder if anyone has ever read something I've put to paper and walked away feeling different, or feeling anything at all. Internally, I wonder if my writing has any impact on me. I've journaled nearly every day for the past three years, all of it introspective and self-analyzing, and I still feel like I miss the forest for the tiny trees; that I've made the biggest mistakes of my life in just the past week, and that while I wrote about being stressed at work or fights with my partner, my journal rarely touches on my sexual assault or my brother's incarceration, two of the most traumatic things that happened to me last year. I wrote about petty fights with my boyfriend, using words to store my bitterness in instead of using them as tools to break apart my outer hardness to find my vulnerability and gentleness inside.

I feel angry with myself. I feel like I've wasted time, or not been productive. I hate that I use the word 'productive' as much as I do. I take stress naps and wake up exhausted, and I check my bank balances every day because I have an anxiety that what I have will be taken from me at any moment. I feel shame, and I don't know for what.

I think this is all called exhaustion. I think this is all called being stressed and overwhelmed and not dealing with grief and taking too much on and ignoring the important things and losing the essential things and turning into the worst part of your parents and then fearing you're not turning into anything worthwhile at all. I want to be more quiet. I want to stare out the window more, I want to read on my couch for hours without worrying that I'm missing something. I want to put my phone in a box and put that box into the closet for the weekend. I feel guilty for not doing any of those things, and no pleasure in the things I am doing.

This is a long intro. This was supposed to be a post about how Texas is shitty and how, since The Voice, I've written about abortion access and rights. I wanted to write about how planned parenthood saved my life twice, by giving me information about my pregnancy that was fair and good and put me forward instead of the conservative agenda my dad put forward, that saw me as a sin and not a person. They saved me too, by giving me access to birth control I couldn't afford. I wanted to write something about all the different ways writing hasn't gotten us any closer to convincing people that maybe women shouldn't have to carry fetuses to term if they don't want to, that they exist as more than just reproductive machines.

But I just feel tired. So I'm keeping this space small, and safe. I am posting below some abortion funds that people can donate to if they feel so inclined, to help people access abortion care if it is no longer safe for them to do so where they live. And I want to hold space for the people who are exhausted and discouraged. It is okay to be like this. It is okay to want to stare at the wall for a little while. Let others take up the mantle when you no longer have the strength to do so. We will be coming back.

Abortion Funds:

• Texas Abortion Funds

• Fund Texas Choice

• Texas Equal Access Fund

• Women’s Reproductive Rights Assistance Project

• National Network of Abortion Funds

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The Whorticulturalist is the mother of this magazine. She is a sex-positive blogger and creative who enjoys rock climbing, dancing, and camping. In her spare time, she’s probably flirting.

Planned Parenthood vs. My High Priced OBGYN - A Study in Comparisons by Jessica Stilling

Photo by Dainis Graveris from Pexels

I work at a religious school, and therefore I get my health insurance through them, which means that I was unable to get them to pay for my IUD (intrauterine device) for birth control. The unfairness of that situation is a whole other article in and of itself but I remember when I first took this job at said very progressive (and apparently feminist) religious institution and spoke with the insurance company about switching my insurance,  a very nice, fresh faced woman said, “Don’t worry about birth control, we’ll figure it out. We feel very strongly about a woman’s access to birth control.” But when I needed to have my old IUD taken out and replaced, the woman I talked to on the phone said, in a very sunny voice, “I’m sorry, we won’t pay for that if it’s for contraception.” I was reminded why I never, ever shop at Hobby Lobby. 

At the end of the day, I couldn’t afford to go to my regular OBGYN for an IUD and so I called Planned Parenthood. And they took me, right away. And they helped me get an IUD, no questions asked. But I was still nervous about going to Planned Parenthood. I wasn’t worried about the stigma of using the non-profit medical facility. I wasn’t worried that I’d walk into a Pro-Life rally outside their doors. But doctor’s offices can get crowded, especially in New York City. The wait once you get into the waiting room can run an hour, sometimes more, past your appointment time, ask any New Yorker who has ever had to see a doctor on their lunch break. And I was worried about that. Would it be crowded? Would it be discombobulated? Would the doctor spend three seconds with me and do a less than perfect job? Spoiler alert, all of my fears were unfounded, my Planned Parenthood experience was great but what surprised me so much was how much better I was treated there than at my regular doctor’s. While I originally decided to explore Planned Parenthood because of price, it turned out things like wait time and convenience were also factors. 

While my entire experience with my insurance and that ridiculous Obamacare add-on that has harmed so many women financially, not to mention medically, is definitely an issue I’d love to explore, here I’d like to compare my experience at Planned Parenthood with the experiences I’ve had with my very nice, very experience Upper West Side OBGYN. First, I should say that I’ve had two children and before my children were born I went to this same gynecologist for birth control for many years and so I’ve had experience with my OB. I also want to say that I live in New York City, a place where even when things are nice and expensive they can still be crowded, full of poor service and long waits - even when you have an appointment. Perhaps if I lived elsewhere I would not have the same complaints about my OB but then again, the Planned Parenthood I visited was also in New York City. I visited The Margaret Sanger Center on Bleeker Street. It’s the only Planned Parenthood in Manhattan. There is exactly one Planned Parenthood in each borough of New York City and as you can imagine, there are countless ONGYNs across the five boroughs. 

After my time at Planned Parenthood I started to wonder not just about my OBGYN but about other experiences with high priced New York City doctors and came to the conclusion that maybe New Yorkers aren’t getting what they pay for.  

Wait Time

When I called my OB to get an appointment for an IUD at first my OBGYN, a woman who had delivered my children, who I had gone to many times throughout the years, could not find my information and asked me to enter their system as a new patient. Then they told me I would need to make three or four appointments in order to get the IUD put in. “You’ll need to come for a consultation, then you’ll need an appointment to take your current IUD out. Then you’ll need to make another appointment to have the IUD put in and you might need a follow-up appointment.” I asked then they could get me in. They told me they could see me for the first appointment in about four months. I thought I had left plenty of time, calling with about two months advance notice before my IUD was set to expire. I never thought they’d make me wait that long. 

Planned Parenthood actually had my information on file from a time I had gone there when I was in college, many, many years ago. I’d never updated that information since I only saw them once, during a time when I was between insurance providers when I was in college. They still had the address of the apartment where I lived when I was in college. They still had my maiden name. But they were happy to update my information. 

I figured that it would take longer to get an appointment with Planned Parenthood than it would my OBGYN and so I braced for a long wait. At Planned Parenthood I was able to get an appointment for three weeks in the future. The system asked me what I needed done and there was an option for “IUD removal and reinsertion of new IUD” right on the menu. It would take one appointment to do all three. That meant that I only had to take off one afternoon from work. I only had to take the long subway ride downtown once. I only needed to pay for one appointment. 

Price

This is of course why I decided to go to Planned Parenthood to begin with. Since my insurance company wouldn’t pay for my IUD it was all going to be out of pocket and we all know that insurance companies can negotiate a rate with a provider but out of pocket payers pay more. When I asked my OB’s office what they thought the IUD would cost they said, “You’ll need to pay out of pocket for at least two of the three appointments, and that’s assuming nothing goes wrong. And you’ll need to pay for the IUD itself. It’ll probably be around $5000.00” 

I honestly went to Planned Parenthood thinking it would cost around $500 for an IUD there, especially since I only needed to do one appointment with them. I was willing to spend up to $1000 before I started to wonder if an IUD was really worth it if I had to pay out of pocket. When I got to Planned Parenthood, ready to write them a check, I was told to go to the Finance Desk. When I spoke with the woman there she was very kind. I told her I was getting an IUD and then asked how much it would all cost. I braced myself as she said, “Okay, that’s free of charge. We received a grant for that, you won’t pay anything.” I asked them what that meant and apparently Planned Parenthood had recently received a grant to cover the cost of IUDs but even when there was a cost to the patient, it was minimal. I will say I wrote a big check (just not a $5000 check) as a donation to Planned Parenthood that day. 

Experience 

I only went to get my IUD once, from Planned Parenthood, and so my comparison when it comes to my experience really goes back to my other experiences with my OBGYN throughout the years. She not only delivered my children and was my primary OB for many years, but she put in my first IUD, the one I got after I had my second child. 

Wait Time

The usual wait time at my OB was about 45 minutes. There were times when it took an hour, other times when it took thirty minutes, but I always waited. And I understand why, sometimes an OB gets called away to deliver a child or handle an emergency. But there are other less noble reasons for a long wait time at the doctor’s office. I’ve also read about overbooking and how many doctors are forced to overbook to cover the cost of rent and insurance issues. But I would usually wait 30 to 45 minutes before I was called back to get my vitals taken by a nurse. I would then wait another 10 to 15 minutes for the doctor. 

When I went to Planned Parenthood they called me right back to speak to the Finance Department, where they promptly told me I owned them nothing. I then waited all of five minutes to be called back to the nurse, who explained the process of IUD insertion to me. She also explained the basic differences between the two types of IUDs they offered. She counseled me on which IUD to choose and then asked if I wanted to get tested for any STDs. She took my blood, she took my vitals. Then she sent me back to another waiting area. I took out my book, thinking I’d be waiting a while only to be called back to the doctor about 5 minutes later. I remember being a little let down that I hadn’t gotten to read more of my book.

The Doctor

This is where the comparison is much less. Both my doctor’s were great. I like my OBGYN. We would always chat a bit before getting started. She had a dry sense of humor that I enjoyed. She did her job, had a nice bedside manner. Her staff was very friendly as well. But even with all the small talk, I was usually out of her hair in about fifteen to twenty minutes. 

The doctor at Planned Parenthood was very friendly as well - all smiles and she was really willing to talk to me. I had a few questions about the type of IUD to use. In fact I told her (this might be TMI) that I hadn’t really had a steady period in many years. The doctor paused, then she said, “Actually with this new information I would recommend the other IUD. It is said to be better for women who do not have regular periods.” I won’t go into the medical nitty-gritty of what she said, but basically she did a very good job explaining in both medical (with her sources cited, she checked and showed them on her computer which was right next to her) and then in layman’s terms, just why she thought I should go with the other IUD. She then went through the process of going through the paperwork to change the IUD. A few minutes later, she took my old IUD out and reinserted the other. The experience wasn’t pleasant, but it wasn’t painful. She gave me a maximum strength aspirin and then left the room so I could change. After I had changed she returned to debrief and I told her, “I just want to say, you guys do great work here.” We then had a ten minute conversation about Planned Parenthood, woman to woman, feminist to feminist, before I left her exam room. 

I left feeling taken care of and respected as a person and a patient. The doctor spent nearly an hour with me from the time I entered the exam room to the time I left and when I left her office and returned to the waiting room, it was not crowded, only a couple of people were waiting, which seemed to say that even when the doctor spent so much time on a patient, other patients were also being taken care of. 

The Facilities 

Obviously my Upper West Side doctor’s office is very nice. The walk there is pleasant, it’s near a subway station, when you go inside the chairs are nice, it is air conditioned/well heated. It is well lit. There is water out for the patients. There is not a lot of noise and there are many magazines for people to read. 

The Planned Parenthood that I went to is also in a nice neighborhood - the East Village of Manhattan. It had been in the area for a very long time and I know that the East Village wasn’t always a nice place to be. However, when I went, it was a pleasant stroll by book stores and bistros, hipsters wandered the streets alongside business people and moms in yoga pants. The neighborhood is not for everyone, but it’s pleasant. There was more security when I walked into Planned Parenthood, which is to be expected when its doctors are constantly receiving death threats. My bag was searched by a security guard and I had to walk through metal detectors when I came in. The space was large and there were many rooms of chairs for people to sit. They did not have water out but it was well lit and decorated in a modern style. There wasn’t any reading material out for patients, except materials relating to Planned Parenthood and its services. 

Cavate 

I understand that this is just one experience that I had with Planned Parenthood and that other people may have had vastly different experiences. I also understand that I went to the flagship Planned Parenthood in Manhattan and if I had gone to a Planned Parenthood in a small town or in the Bronx, where it is located in a much more inner-city area, I might have seen different sights and had a vastly different experience. But I wanted to explore not just my personal experience with Planned Parenthood, but the fact that my experience differed so much to my experience with my own OBGYN, who is also based in Manhattan. 

Analysis 

The questions I really have after considering both experiences are not, why was my Planned Parenthood experience so pleasant, but why isn’t my regular OBGYN more like this? Why do I wait so long for an appointment and then have to wait so long to see the doctor once I get there? Why did my doctor want me to make three appointments when Planned Parenthood only wanted me to make one? What I found so interesting about my two different experiences really comes down to money. My OBGYN is paid mostly through insurance companies and so she stands to make more money charging for three or four appointments to do a procedure that Planned Parenthood did for me in one single one hour visit. My OBGYN gets paid for each visit, Planned Parenthood usually doesn’t get paid anything for a visit and so it incentivises them to do what they need to do without asking a patient to come in for multiple appointments. The difference in wait time for appointments and the wait time in the office’s waiting room also comes down to money, as more and more doctor’s offices overbook so that they can cram in more appointments, and therefore more insurance dollars. I did not sacrifice anything as far as care at Planned Parenthood. My Planned Parenthood doctor obviously cared about my health, just like my regular OBGYN does. I remember being very nervous to go to Planned Parenthood, and it turns out not only were those fears unfounded but I had the best experience at a New York City doctor’s office that I have had in a very long time.