Fertility vs. Virility

Gerber Daisy in a pot

“I need help,” she pleaded. “I don’t know where else to turn.” 

“Sure. What do you need?”

“I’m pregnant.”

She was newly married. They were recent college grads, just starting their first jobs and their lives together.

“Congratulations! How exciting!”

Her face crumpled and she began to cry great body wracking sobs. I braced myself. Had he left her? Was she being abused? Was there something wrong with the pregnancy? Had she lost her job somehow?

“My health insurance excludes coverage for birth control. The pills make me so nauseated and the depo provera shot just made me bleed and bleed. I couldn’t afford to pay out of pocket for other forms of birth control. So we used condoms. We tried to be careful.” She whispered hoarsely, “I don’t know what to do.” There was terror in her eyes. “My insurance policy excludes coverage for pregnancy. We made calls. All of the OB’s in the area want at least $10,000 up front in cash. We don’t have that kind of money. We have student loans and a mortgage!”

Could health insurance DO that? Exclude coverage for both pregnancy AND birth control? Oh, yes. Yes they could. And it was always hidden in the fine print. It was the young women starting out in life that didn’t know what to look for, the ones most likely to end up pregnant. 

It made me angry for her. What kind of misogynistic world did we live in where this was allowed? Where women are punished for possessing a functional uterus? The United States of America. The bastion of freedom and democracy.

We talked about her applying for Medicaid. 

It felt wrong, though. A woman… married, employed, insured (sort of, apparently) having to apply for Medicaid. That was not what Medicaid was intended for, was it? Once her dates were calculated, the pregnancy predated her employment contract and would have been considered a preexisting condition anyway, even if she did have pregnancy coverage. No matter what kind of policy she had, she was screwed. Literally and figuratively.

The other thing, which no one talked about out loud, was that the OBs who took Medicaid in the area were typically so awful no one with real health insurance would ever willingly use them. There was a huge stigma attached to it all.

So what happened to her, you ask?

She had an abortion.

Despite what you want to believe, hers was not an isolated story.

What a relief it was when the Affordable Care Act worked to changed that. No matter whatever else you felt about the ACA, it was a powerful step forward for women but even it did not go far enough. We all deserve comprehensive medical care that takes care of our entire bodies, not just the parts that correspond to our male counterparts.

But here we are with some people thinking it would be great to go back to that alternate kind of reality.


Be careful what you wish for.


121 thoughts on “Fertility vs. Virility

  1. I can not believe that a country like the US of A can be like this. In Ballarat, for example, there is a huge Private Hospital right next to a huge public hospital. There is an overhead walkway that joins them both so that doctors can walk from one to the other whenever they need to. Every body pays a 2% levy on their income tax the covers the Medicare system. If you want a private doctor you get private cover. If not you might have to wait a bit longer and often you get the same doctor anyway. What is the problem? I’ve never been able to see why it is so difficult for a country that can put a man on the moon and build weapons of indiscriminant destruction and drones.

    Liked by 14 people

    • Sir you are so correct. This is what a country gets when the politicians begin to look like countries with despots/dictators and the like. The US is all about greed and control by the insurance companies, utility (oil and gas) and the pharmaceutical, companies. There is constant lobbying and that needs to stop.

      People don’t read and some just watch Fox news or believe what they see on You Tube. We have been had and yet the supporters of the current admin. are still defending the man that was elected. Frankly I don’t see it getting any better. I happen to be very grateful that I worked for the US government for 35 years and I don’t have much to worry- at least not yet. But my heart bleeds for those people who don’t have or can’t afford insurance and if they can it’s a crap shoot to get insurance that one can afford and or pays decently. It is just a dang mess and the politicians had better wake up.

      Liked by 5 people

      • And I hope sensitive doctors don’t have to carry heavy memories like this all through life. Or can you catalog them and pack them away in a basement and bring them out only when they are helpful in treating new cases? I think your work probably as demanding emotionally as it is in all those other ways you write about. I have an appointment with my doctor today. I’m going to ask him how he manages. But first I’ll thank him.

        Liked by 3 people

      • I think was all get good at filing them away for future times but we do hate to see all of that hurt. Thank you for thanking your doctor. Those two little words are very powerful. πŸ™‚

        Liked by 1 person

  2. And it gets “better.” Interesting timing on your post, because not more than30 minutes earlier I got a news blurb update from the Washington Post, which read: Trump to propose slashing Medicaid, giving states power to limit other safety-net benefits The president’s budget proposal, set to be unveiled Tuesday, would follow through on a House GOP bill to cut more than $800 billion over 10 years from Medicaid, people familiar with the planning said. The White House also is expected to call for changes to anti-poverty programs that would give states new power to limit benefits and impose work requirements. The proposals come despite growing unease in Congress about cutting the safety net. And before we get all excited that Trump’s impeachment seems more likely, how wonderful do you think women’s health care is going to be under a president Pence, he who can’t have a meeting with a woman without his wife present, because apparently he’d get raped. Or something. American Taliban…it is real, just our version has a different fundamentalist religion.

    Liked by 4 people

    • I read the news, mouth agape, and wonder if there is any hope for us anymore. Perhaps I am too doom and gloom but I don’t understand what is going on. I wasn’t sure I was going to like the ACA and there are plenty of parts of it that I don’t like, but it has done some good.

      Liked by 5 people

      • Speaking as one who not only worked as a mouthpiece for the ACA, but as one who benefited from it: The ACA was far, far from perfect. It was a mess created by too much committee and appeasement. But as you say, it has a lot of good in it. What I don’t understand is people like one of the bitchy idiots I work with, who brags about her lack of knowledge and giggles like it is a good thing (and she’s nearly 40 and a single mother of two, oy) who even works in the industry and still didn’t know the difference between the hated “Obamacare” and the pretty good ACA, and why are “they” trying to take the ACA? Kill me now. (Or just let the GOP keep whacking away at health care, the 99% will be dead soon enough from it.)

        Liked by 4 people

  3. Poor thing. And I am sure it is something that will haunt her for life. For someone like me who grew up fighting for equal rights and health care for women, the current state of affairs is so bothersome to me…. it… it … I don’t have a proper word for how much is pisses me off.

    Liked by 5 people

  4. Over here in Finland, health care is free or provided for a very low cost. Pregnant women are monitored tightly throughout their pregnancy, everything done to make sure the baby is born healthy. After that, there are continuous appointments to check the baby’s development, etc. Such a scary situation that must be, to not know where to turn to for help, to not be able to afford health care.

    Liked by 8 people

    • Everyone I know who lives in Europe and Canada are always just aghast at our healthcare “system.” And that is when it was still improving. With the elections, well, let’s just say, America isn’t being “made great again.” I never thought I’d see all this stuff in my lifetime (or really, ever again).

      Liked by 7 people

  5. How can I “like” this post when it leaves me so furious? In my years in Human Resources in the US, I heard so many stories like this–people who were not doing the jobs they could have loved and were meant to do because they had to settle for the ones with health insurance. People who couldn’t afford to accept new opportunities, move, or start businesses because their families needed the health insurance. I remember a young mother sobbing in my office as she told me she was turning down a fantastic outside offer of a training opportunity, and instead would have to stay in her dead-end job because her child (who had been hit by a drunk driver) would need a lifetime of ongoing treatment that would always mean insurmountable preexisting conditions.

    As the one who negotiated the medical insurance for our company, I had to make ridiculous choices with the money we had available–cover maternity? Cancer treatment? Transplants? Mental health?

    In all the complaints about the cost of the ACA, nobody ever racks up the cost for a nation of people who are under-employed, of businesses that are never started, of decades spent doing a job because it has health insurance instead of doing the job you would be best at.

    We now live in the U.K. Taxes are high and the National Health Service isn’t perfect. But a person with a van can start a business without having to worry that their family will lose everything because someone has a brain tumour or needs a bone marrow transplant.

    America, we should be ashamed.

    Liked by 9 people

  6. * She had an abortion* I had a feeling that was coming and I felt terribly sad for her.
    The land of the Free and the Home of the Brave! There is a lot I admire about America but I read these things and I give thanks that I live in Australia.

    Liked by 5 people

    • She was, admittedly, one of the more extreme cases. Most just took their lumps and enrolled in Medicaid or paid out of pocket. All of that was often compounded by the lack of maternity coverage and support that is still rampant. Sure, you can use FMLA now to keep your job for up to 12 weeks but most don’t have any sort of income during that time. I was lucky to have a disability policy that paid me something during my six week maternity leave but then I had to pay a locum to come cover my practice and I was still tens of thousands of dollars in the hole when all was said and done.

      Liked by 2 people

  7. This is shocking and I am glad you are writing about it. Have we have come so far just to go back to the dark ages? All the emphasis on the importance of prenatal care for the health of mothers and babies, to prevent birth defects and high cost of premature births. And how can young couples pay in cash for obstetric care? I can understand how bearing witness to this can tear your heart out. More important reasons to oppose any changes in our healthcare that would allow this to happen again.

    Liked by 5 people

  8. My daughter has had a job, part or full time, since she was sixteen. Last year, when she fulfilled a dream of moving to New York, her biggest thrill was telling me she had full coverage health insurance. 27. Excited that she had health insurance. I’m grateful and at the same time sad something basic in other countries is like getting a golden ticket in ours. Anger falls right behind that emotion – working on keeping that one in check.

    Liked by 4 people

  9. You’re definitely right that this is outrageous. However, most of the people I know ended up with MUCH higher payments for their existing health insurance after the Obamacare, and those who did not want to pay more ended up paying a penalty for not having an insurance… So no, nobody wants to go back to a bad system, but the new one was not good either… I’m not even sure what the solution is, if there is any. It seems all the options are bad at this point… 😦

    Liked by 2 people

  10. Yep. And a big group of Trumpster Fire’s followers will now have the same thing happen to them too. Hope they’re glad he’s gonna build a wall, is apparently in collusion with Russia and that peach of a guy Putin, and sell weapons to Saudi Arabia. That’ll make it all better.

    Liked by 1 person

  11. There are many more stories like this that aren’t told and I thank you for sharing.

    After struggling to conceive the Sassy, I quickly and unexpectedly received a Moo. My Moo was much more determined than the condom or the insert. I felt like fertility waited for the most inopportune economic situation ever. I feel I can never convey the full irony of this situation.
    I wanted a Moo, but maybe 3-4 years later.
    I was, however, glad to have insurance coverage. We paid $4000 for Moo, and I won’t complain, because that was literally a tenth of the bill. I remember noting that my husband’s insurance coverage paid for 90% of all OBGYN stuff. Prenatal, all testing, childbirth, c-section, was 90% — and that it covered NO birth control of any reason — no pills, no shots, no IUD, no tubal ligation — for any reason and yet, it paid 90% of his vasectomy. If that isn’t anti-women’s choice — totally and completely sexist, I don’t know what else we’d call it.

    Liked by 3 people

  12. I don’t see those anti abortion folks standing up and screaming about these proposed healthcare law changes. Yet, this is the inevitable result of them.

    One of the key changes to pulling an economy out of a spiral of poverty is birth control. That simple thing. Giving people the ability to plan a family. We used to know that in the US. That’s why we created Title X, but now that’s about to be a thing of the past.

    We are walking backwards while other countries are moving forward. And the way we handle healthcare is just one barometer of it.

    Liked by 2 people

  13. India with its starving millions still offers better healthcare for pregnant women, for the most part. And I could never understand this clause denying cover for pre-existing conditions. Only the healthy need insurance, not the sick? And pregnancy is a pre-existing disease? Ok, I’ll shut up now, before I get worked up before my work-out.

    Liked by 1 person

  14. This is so shocking. We (in Aiatralia) are so lucky to have a public hospital system and free or subsidised health care options. You’re right- it’s mysogynistic and overall seems to be government forgetting that they represent the people. The pre- existing conditions that disadvantage women under trump’s proposed changes to obama care are appalling.

    Liked by 1 person

    • Yep. Back then there were plenty of policies that excluded well child visits and vaccinations and parents who didn’t know until they got that $1200 bill. Vaccinations are crazy expensive.


  15. I don’t know if this will work in the US because healthcare costs there are much, much higher, but perhaps you can consider a similar setup? Where I live, a lot of hospitals offer pregnant women a “package deal.” It’s not a very good term and that’s probably not the official name for it but that’s how we call it. The deal is: for a cheap “package” price, all the prenatal check-ups and the delivery itself are handled by OB-GYN residents. Part of the terms of the deal is that if there are any abnormalities discovered, anything that needs to be handled by a full-fledged obstetrician, you can’t continue with the program, you’ll have to get your own obstetrician. Otherwise, the residents handle you: they get the training and you pay a minimal amount. Five years ago, the “package deal” price was around $200 for normal delivery and $1000 for CS, which is around, oh, 40% of what it would cost if you deliver in a private hospital and have your own full-fledged obstetrician. It’s not a complete solution, obviously, but at least the normal pregnancies would be one less thing you have to worry about.

    Liked by 1 person

    • I have read that here it costs something like $18,000 for a vag delivery on average and $36,000 for a Csection on average. It is appalling what the US pays compared to the rest of the world. In my residency program we were Medicaid providers and were contracted to do the indigent care so if you showed up at the hospital with no insurance, you got one of us. We couldn’t pass off the complicated deliveries to private OBs, though. We were it, though we had a couple of attendings that would help us out in a pinch. They did the c sections with us assisting.

      Liked by 1 person

      • Oh, I see…so it goes back to opting for Medicaid then… 😦 Mind you, for a lot of the indigent in our country, $200 is no joke either — they wouldn’t be able to afford it and would have to resort to government hospitals where the treatment they get would be less than optimal. And pregnancy is not covered by private health insurance, either, and our national health insurance only pays very little (less than $200) for maternity care. So we definitely don’t have a model healthcare system. But for someone here who had a job but not a lot of money saved up, like your patient, the “package deal” would have been a good option. I hope someone there comes up with a similar out-of-the-box solution that would let a young woman keep her child if she wants to (and not only when she can afford to).

        Liked by 1 person

  16. It does seem strange to be so worried about the unborn you won’t pay for proper care for their mothers…to be so worried about abortions you won’t pay for birth control so that abortions aren’t necessary…and to abandon caring for the human life you value so much once it is born and alive. A pox on them all. There’s not enough bad karma to send their way. (K)

    Liked by 1 person

    • Providing good emotional, social, and medical support for women would go a long way to curbing abortions. Instead we have this sort of brutality perpetrated against women and many of those against abortion think this would be OK to do again.

      Liked by 1 person

      • How can we have people with no decent access to birth control, no insurance to cover prenatal care, no options for terminating the pregnancy, and no coverage for child wellness? I mean what the actual F*ck. America.

        Liked by 1 person

  17. I felt ill reading this post and I want to cry. This poor woman was in a no-win situation.

    I’m an outsider and I have no right to say this, but your country really has its priorities screwed up 😦

    Liked by 1 person

  18. When there are monopolies or price fixing collusion in service or industries, the only loser is the consumer.. That’s bad enough for nonessentials.. Utilities and health services are regulated but far from the consumer’s best interest.. Essential services and products should have a strict profit margin cap to protect citizens from paying ransom for their own well being.. If this was done, then these services and products would be forced to earn business rather than just be in a position to wield it like a sword.. Efficiency standards would change from giving less to the consumer, to, eliminating outrageous bonuses and lavish management getaways disguised as seminars..
    Customer Service, would actually be that..
    As far as pre-existing conditions and anything maternal, discrimination should not be allowed.. There should be no clause of pre-existing, period.. I also believe there should be no maximum limit of benefits..
    Insurance companies are nothing more than a casino.. You as the patron pay money (premium) for a payout, if and when you need it.. The House (Insurance company) is betting to bring in premiums at a higher rate than having to payout.. The game is of course rigged in favor of the House.. Deductibles, co-insurance, U&P rates, limited benefits and exclusions.. Pre-existing conditions, were supposed to be a non issue under obamacare..
    As of May 4th now, if you let your insurance lapse, then a company can charge a surcharge to your premium, for a pre-existing condition .. There’s a couple of programs to offset costs for people in those situations, but I don’t see the sense in allowing the pre-existing conditions clause to be used by insurance companies at all..
    There is one daring thing we all can do that would bring the insurance company execs down from their ivory towers.. By law, no hospital, public or private, can turn anyone away in a medical emergency, regardless of ability to pay.. If everyone, currently not under treatment or prescription, didn’t pay their premiums at one time, giving notice to all insurance companies prior to doing it and why, the companies would be forced by the consumers to
    restructure fair business practice and rates that the consumers find fair.. The downside is, in today’s society, getting 1000 ppl on the same page at the same time to do one thing together, probably isn’t happening.. This would be tens of millions of people.. And there would have to be demands.. The shorter and sweeter, the better.. All the best ideas fail without commitment.. That’s what I think consumers lack and it’s a shame.. It’s their only weapon but one that works when put in action..


      • It’s all about risk whether it’s the insured or the insurer.. Which is why I’m deadset against aflac type of accident/injury insurance.. I find the rates outrageous for the payout/terms and restrictions..
        The government could be the answer healthcare, but I don’t think it’s the best answer.. It would have to be watchdogged so closely, that keeping it privatized is better in my opinion, for the general population.. But that’s the rub.. The general population has to fight back the health field, insurers and big pharma, right in their wallet.. They would be forced to give in or go out of business.. The biggest financial handicap Americans have, is they don’t stick together for change.. We let govt and business tell us what is acceptable.. When it SHOULD be the other way around πŸ˜•
        We all have a right to gripe but not a leg to stand on for sympathy.. We together, let this happen.. People have the power if they’d just quit playing into the garbage that divides us.. The people who gain the most from America’s lack of citizen cohesion, are the politicians and big money movers.. They laugh at the masses as they manipulate them..

        Liked by 1 person

  19. If things continue in this direction, I’m imagining less prenatal care and more home deliveries. Go fetch Aunt Sally and I’ll boil some water. But we know that would increase deaths in babies and mothers. I hope sanity will miraculously intervene.

    Liked by 1 person

  20. I hope the coming years will not undo all the work of Obama’s AHCA.

    As the President is trolling the world, his country is falling apart. Then healthcare becomes something for people with medium to high incomes (regarding affordability). Even ambulances and ER are at risk of being cut.

    Sometimes people forget that being a mother is the hardest job on the planet. Disrespect mothers and you have some explaining to do. Pregnancy is making life possible for a little human being.

    Objectifying that to a pre-existing condition sounds almost criminal…

    Liked by 1 person

  21. I shouldn’t say this because I know folks in the states dislike hearing their county criticised by others but the American healthcare system has always struck me as completely barbaric. But then I’ve had knackered uninsurable knees since the age of 8 so I guess I would say that.

    Liked by 1 person

  22. In 1999, my wife got pregnant with twins. We didn’t find out until April of that year that there had been a clerical error and she was never added to the company’s policy. They told the company we worked for that they would have to submit another application to have her covered. Mind you, the company had been taking premiums out of her check.

    The insurance company, Blue Cross I believe, denied her coverage because of a pre-existing condition. The condition? Pregnancy. It didn’t matter that a clerical error prevented her from getting coverage before she was pregnant.

    Luckily, the twins’ births were covered under my insurance, but all of her prenatal care we ended up declaring bankruptcy on, because, there was no way. I mean, twins are high-risk so the last couple months of her pregnancy she was in the office three times a week for stress tests and ultrasounds.

    It was ridiculous.

    Liked by 1 person

  23. Great post. People think that cutting the ACA is doing something when the only people who get rich are hospital executives and politicians. You should never have to worry about being pregnant when you have health insurance.

    Liked by 3 people

  24. My daughter’s (the MD) health insurance plan did not include birth benefits. Zip. Zilch. Fortunately, being doctors they get special rates at the hospital they work at, and Doctors here never charge another doctor. (Even parents! Some doctors refuse to make me pay because my daughter is a doc)
    Yes, that is where we are going. And the orange man just pushed the Premier or President of Montenegro away to be at the centre of the picture, at Nato, UE, G7 or whatever… Yes, he pushed him aside. Of course he picked Montenegro not Germany or France.
    The world needs impeachment now…

    Liked by 1 person

  25. So scary! I’m Canadian, and we have many worries that universal health care does not cover.
    However, our basics are covered. All to be mothers get full care, no matter the situation.
    It’s not perfect here, but we try, and it is human caring.
    I accept that America is a capitalist democracy, not a socialist democracy. I’ve always adored America, and still do.

    Liked by 1 person

    • Each has its drawbacks but compassion goes a long way toward filling in the gaps, something that much of healthcare in the Us is lacking of late. As an aside, I loved that you took the photos in your dress. You are beautiful! πŸ™‚

      Liked by 1 person

      • Oddly enough, scary as it was, I’m glad I modeled for the photos, too. I feel fierce, and I should. I’m staring down my own personal fears, one day at a time.

        Liked by 1 person

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