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    Maison Fioravante

    Navigating a Pelvic Mass and Chronic Health Issues in a Post-Roe USA

    Hi, there fellow humans, I’m Maison. My pronouns are she/her, I am a 26-year-old cisgender (identifying as the sex I was assigned at birth) woman and I have been living with multiple health conditions my entire life including but not limited to: severe widespread chronic pain, disk herniation, and lower back arthritis (as well as in some other places), PCOS, lymphatic issues, chronic wounds, and most importantly, it seems, a rare and still undiagnosed genetic overgrowth syndrome that affects my right leg and foot since birth. My overgrowth syndrome has also caused some overflow of my adipose tissue that composes my leg into my pelvis. On June 24, 2022, as most of us with uteruses know, the United States Supreme Court abolished federal protections for abortions that were previously protected under Roe v. Wade which came into effect almost 50 years ago on January 22, 1973. Since (formerly) being in place, not only cisgender women, and people of other gender identities with uteruses, have had the federal right and protection to get an abortion dependent on state laws for certain gestational periods of pregnancy. However, since it has now been overturned, abortion laws are up to each individual state. Prior to Roe v. Wade being recently dismantled, many states had “trigger” laws, which, according to Wikipedia’s definition, is a “nickname for a law that is unenforceable but may achieve enforceability if a key change in circumstances occurs.” Ever since I was a little girl, I have dreamed of becoming a mother, and hopefully having the ability someday to carry at least one of my own children someday if my health issues allow me. I felt comfortable until recently, to know that if goodness forbid, I would need to terminate my pregnancy for any reason (not that I would want to unless absolutely necessary), including for my health and well-being, my rights to that abortion were protected and basically guaranteed in my state of Pennsylvania. At the moment, abortion rights are still protected under Pennsylvania law, but our future as Pennsylvanians is hazy as we are expecting a new governor come election time, and each candidate has very different opinions on abortion. If we consider just Democratic and Republican candidates, our democratic candidate, Josh Shapiro, is pro-abortion rights, and our republican candidate, Doug Mastriano, has proven his views to be highly against upholding abortion rights for Pennsylvanians. Speaking more about my personal health, I had always thought for a long time that I would be able to not be considered a high-risk pregnancy, albeit I was diagnosed with PCOS, (a condition which causes cysts on the ovaries as well as hormonal issues and oftentimes infertility in those who have it), at age 14. I had experienced heavy and extremely painful menstruation since starting to menstruate around age 10. I remember being at a gynecologist appointment with my mother, maybe around the age of 16, and having a more in-depth discussion with my former OBGYN and my mother (who I am so incredibly close with to this day as she is not only my mother, but my best friend and full-time caretaker) asking if I would be able to have children someday and my doctor had replied that it was more than likely. However, as time passed and my other health issues (like my overgrowth syndrome that affects my leg continuing to grow as overgrowth syndromes typically do, etc.) continued to make themselves more well known, I started to gain an immense amount of doubt about my possibility of becoming a biological mother carrying my own child. Flash forward to now as a 26-year-old woman. I would have no problem when the time is right to have children with options such as surrogacy or adoption, but I still cling to the hope of being able to at least try and carry my own child. Those hopes were somewhat crushed when I heard that our Supreme Court had abolished federal protections for abortion by dismantling Roe v. Wade. The day that it happened, I had a major news network channel on television broadcasting a talk show, and it suddenly went to a breaking news segment: Roe v. Wade no longer existed in 2022 America. I grabbed my phone (as my boyfriend lives in England and I wanted to show him what was going on) to record the television while half-screaming expletives in disbelief. At that moment I knew things were going to change across the nation and not for the better for people with uteruses. Since the ruling happened, I’ve really begun to ponder my future, which has been accompanied by some tears that weren’t all based on the chronic pain I feel. I asked myself a lot of questions, played out scenarios in my head, and the list goes on. In truth, I cannot deny that this whole ordeal scares me for many reasons. It scares me for the countless people this decision will affect, especially minority communities (as minorities of different types are statistically and historically most likely to be affected) like people of color, those with disabilities and health issues, LGBTQ+ individuals. I identify as pansexual and queer (although in a “heterosexual presenting” relationship) and am disabled. As stated previously, ideally I would like to carry at least one of my own children. Whatever happens after that is left to some semblance of fate. But what happens if I get pregnant someday? If I do, goodness forbids I need to terminate my pregnancy for some reason and my state changes its course on abortion rights protocols. This is why voting is integral as well as protesting and speaking our minds to fight for our rights. We as Americans need to make sure to do our research before it is time to vote for new persons in office and make sure they will fight for our right to abortion and other basic human rights, we need to show our governing body that we will have voices heard. I am very much for the sentiment of “my body, my choice” as I couldn’t even imagine telling someone else what to do with their body and their health because of my personal views. People like me, and anyone really, should not be denied the choice when it comes to abortion, because abortion is truly not an easy choice to make regardless of the reasoning. I should be allowed to try and carry my own child, and if I need to terminate that pregnancy for my health and well-being, it should be thus. My fingers are crossed for the best, and you can be assured that I will be voting come November. On a final note, I would like to add this: people in America with uteruses, and those without who stand for abortion rights…I see you, and I stand with you. Together there isn’t anything we can’t do. We will prevail.

    Megan Glosson

    What Makes a Good OBGYN vs. a Bad OBGYN

    I have a confession to make: I hate doctors’ appointments. I live with multiple health conditions, which means I’ve gone through my fair share of bad doctors, which is why I often avoid seeing primary care doctors and even specialists as much as I can. However, one doctor I’ve always had great experiences with is my obstetrician/gynecologist. Since my first appointment with her in 2012, she has consistently shown professionalism and compassion. She’s dealt with my trauma responses related to past sexual assault, cared for me through two pregnancies and one miscarriage, and remained calm when I disclosed my same-sex relationship. I realize that my experience may not be the same as everyone’s, but I do think that my doctor has helped me realize there are certain qualities that make a good OBGYN versus a bad one. A good OBGYN is trauma-informed and understands how trauma may impact a patient. One in four people experiences at least one traumatic event before their 18th birthday. This means that at least 25 percent of the individuals who step into a gynecologist’s office have experienced some form of trauma at some point during their life. Regardless of what form of trauma a person experiences or whether they have a PTSD diagnosis, that past trauma can impact a patient during vulnerable moments such as a pap smear or other vaginal health exam. A good OBGYN recognizes that trauma may impact people, and they take active steps to provide trauma-informed care to every single patient they see. This means the provider takes time to establish trust, make the patient feel safe, and empower the patient during all interactions. This may require some modifications to exams and other protocols, and it may mean the doctor needs to spend additional time with certain patients. However, it’s all for the benefit of the patient, and this should be a physician’s top priority. A good OBGYN explains procedures before they begin and throughout the process. Bedside manners involve so much more than putting on a smile when you enter a room. Good patient care includes addressing each person’s concerns and making them feel at ease. In many instances, this special care includes procedure explanation and constant communication throughout any work performed. Most patients, even those who don’t have a trauma history, appreciate it when providers explain procedures and walk them through the process. This simple gesture eases anxiety, shows compassion, and avoids misunderstandings that can occur through assumptions. Therefore, any OBGYN who is decent at their job will tell patients what to expect and, at the bare minimum, announce the steps of the process as they perform them. A good OBGYN seeks out continuing education. The field of medicine is constantly changing, just like every other thing in the world. Therefore, it’s important for OBGYNs to stay up-to-date with medical knowledge and news that may impact their work. Doing this requires more than just turning on the news every once in a while, though. It involves putting forth the effort to continue their education. OBGYNs can take continuing education courses on a variety of topics. For example, they may elect to learn more about sexual dysfunction or sexually transmitted infections. They may also want to learn more about caring for nonbinary and transgender patients who need reproductive care. A good OBGYN provides patients with information so they can make informed decisions about their care. When a patient needs treatment for an illness or health condition, there are usually multiple options available. Any good medical provider takes the time to share all the information they can with their patient about their health and all the treatment options they can pursue. For OBGYNs, this is especially important since they deal with everything from pregnancy to conditions like PCOS and endometriosis. A good OBGYN takes a non-judgmental stance with each patient they see. All doctors see a wide variety of patients. However, due to the nature of their specialty, OBGYNs deal with a lot of unique information from their patients. These doctors may provide care to sex workers, people who lack knowledge in how to properly care for their vagina, individuals dealing with post-partum depression, and other unique patients. Regardless, a good OBGYN understands that all humans deserve proper care and these aspects of a person don’t make them less worthy than others. These doctors take a non-judgmental stance with every patient they see and focus on providing the best possible care for each person based on what they need. A good OBGYN delivers difficult information in a compassionate way. Unfortunately, an OBGYN’s job doesn’t just involve pap smears and delivering healthy babies. These doctors also have to dish out their fair share of bad news. They may have to tell a person they’ve lost a pregnancy, they may have to share news of an STI, or they may even have to deliver news about a terminal health condition. Regardless, a good OBGYN delivers this difficult news with compassion and concern for the patient’s emotional well-being. A good OBGYN is mindful and accepting of all patients who require their care. A good OBGYN does a lot for their patients. However, all of this care boils down to one simple thing — acceptance. A quality medical provider demonstrates acceptance with every patient they see, regardless of their appearance, their past, or any other part of their identity. Great doctors are mindful of how various aspects of a patient’s identity may impact their interactions and responses, and take this into consideration. They also go the extra mile to make sure all patients feel welcome and accepted every time they come in for an appointment or treatment of any kind.

    Monika Sudakov

    How the End of Roe v. Wade May Affect Privacy With Your Therapist

    With the reversal of Roe v. Wade, discussions regarding how this will impact the lives of those with a uterus have been swirling. It goes without saying that this decision has far-reaching implications that many of us haven’t even thought of. One of these involves the ways in which changes will be made for therapists and therapy in states where trigger laws have gone into effect and abortion has effectively been outlawed. The American Counseling Association issued the following statement on June 24, 2022: “The Supreme Court decision striking down Roe v. Wade abolishes women’s constitutional right to choose to have an abortion without the undue influence of government. This decision will trigger some state regulations, which will make abortions outright illegal and/or limiting accessibility. Various jurisdictions have proposed laws and regulations that require clinicians report clients who have sought or are seeking an abortion, as it may be considered ‘aiding and abetting.’We recognize that the loss of access to safe, legal abortion may hinder the ability of women to participate within the workplace and society effectively and successfully. Unwanted pregnancies may affect women’s education, employment, earning prospects, and health. These effects would disproportionately fall on those who are already marginalized, those living in poverty, people of color, nonbinary, and transgender people, as well as those who live in medically underserved areas (e.g., few primary care providers, high infant mortality, high poverty).Overturning Roe v. Wade means we can expect an increase in economic hardship and insecurity that may lead to increased stress, lower life satisfaction, decreased work productivity, increased turnover, and decreased mental well-being. Professional counselors assist clients and students facing life’s challenges such as the deeply personal decision to have an abortion, and how to access such services.The American Counseling Association (ACA) stands with every person, counselor, and client in pursuit of mental health care and wellness. Professional counselors are being placed in an unethical position. In counseling, clients are entitled to self-determination and to make decisions in the best interest of their health and well-being. Clients should have access to high-quality professional counseling without the fear of having their confidentiality unjustly waived. This requires safeguarding the integrity and trust built in the counselor-client relationship.Professional counselors need to continue to practice ethically and obtain a legal consultation to determine their duty to confidentiality and privacy versus the conflict either in Roe v. Wade or the restrictions their state has put in place. Professional counselors may request an opinion from their State Attorney General who can give an official interpretation of the law.” Obviously, this spawned a bit of a panic in the mental health community as to what liability, if any, a therapist might incur should a client disclose the intent to obtain an abortion. Many rumors circulated that therapists would be required to report their clients under “Duty to Warn” laws, which are normally reserved for the protection of children or the elderly where abuse has been disclosed. While not every state has these requirements, even in those where they aren’t mandatory, therapists may act so as to avoid any potential liability, and this is where the slippery slope exists that has therapists concerned. As per the statement by the American Counseling Association, I attempted to reach out to the Attorney General’s offices of as many states where abortion has effectively been outlawed to find out what, if any, liability or requirements are in place for mental health professionals where abortion is concerned. While most of them had secretaries who took messages from me that presumably ended up in a permanent file known as the dumpster, the handful of states where I actually spoke to someone — namely Oklahoma, Missouri, and Texas — told me that they had no information at this time and that individual mental health professionals should consult with their private attorneys regarding any potential liability. As for consumers, there was no comment or guidance available. The Texas office referred me to the Law Library for more detailed information. I did contact them and was offered the following statement: “The language of the law itself is not specific as to abortion. It states that “[a] professional may disclose confidential information only … to medical, mental health, or law enforcement personnel if the professional determines that there is a probability of imminent physical injury by the patient to the patient or others or there is a probability of immediate mental or emotional injury to the patient.It does not go into detail about what “imminent physical injury” would mean in terms of abortion. In cases like this where the law is vague or unclear with regard to a specific topic, it usually needs to be interpreted by the courts. The Texas Attorney General could also issue an opinion stating how the law should be interpreted and applied. Until then, its precise meaning and application are unclear.” She did include that in Texas this law is “permissive” rather than “mandatory,” meaning the mental health professional “may” report rather than “shall” or “must” report. She then suggested I contact the state behavioral health licensing board, which I did. The Texas board stated that there is no such Duty to Warn “at this time,” which leads me to believe that this may change in the future. Other state boards did not respond to my inquiries with the exception of the state of Oklahoma board which stated “The Board does not have any additional information to provide at this time.” So where does that leave therapists, and more importantly clients of therapy in states where abortion is illegal? I’d say it’s very much a gray area right now. Since there is no precedent yet for how these cases will be pursued if and when they occur, medical providers will be operating in uncharted waters. As the Honorable Judge Rosemarie Aquilina of the state of Michigan outlined in an op-ed for Medscape: “Doctors in some states will be forced to report or even testify against pregnant patients who have abortions or even who have had miscarriages. The cost of malpractice insurance will increase for physicians who treat any woman during their childbearing years…Will I be required to sign probable cause search warrants for information that has been protected under HIPAA, the Health Insurance Portability and Accountability Act of 1996?” And that is the primary thing that clients should be acutely aware of. If you disclose your intent to obtain an abortion to your therapist, even if they are not required by Duty to Warn to report you, should you later get turned in and your medical records subpoenaed by a court of law, anything that is included by your therapist on your progress notes or chart can and will be used against you in a court of law. The ramifications of this cannot be overstated. This leaves patients and therapists with a couple of options. For a patient, you can opt to withhold any discussion regarding your reproductive health from your therapist so as not to potentially incriminate yourself in the future. Or you can hope that you will not get caught and therefore this will be a non-issue. For a therapist, this will be contingent upon whether you work for an agency or in private practice. I have heard of some therapists stating that the agency they work for requires them to report clients who intend to seek an abortion. I’m unclear as to the legality of this being mandated, but it’s something a client should be aware of. And if a therapist is in private practice, they may simply choose to not include any information regarding a patient discussing reproductive health at the risk of having to violate the patient’s privacy should they get caught. None of these scenarios are particularly appealing to either the therapist or the patient. The bottom line: While therapists don’t often like to discuss their personal political or religious beliefs with their clients, this is a situation where an open and honest dialogue needs to be had between a patient and therapist. You have the right to know where your therapist stands on this issue if you are going to feel safe in therapy. The entire underlying tenet of why therapy works is the ability of a patient to be completely honest with their provider. It’s the foundation of a strong therapeutic alliance. If you are having to police what you share for fear of incrimination, you can’t possibly feel safe enough to do any kind of meaningful therapeutic work with that clinician. Your therapist should have a clear answer ready for you regarding their belief and how they intend to proceed in the future. If they refuse to answer or cannot provide you a well-thought-out plan of action, I recommend searching for another practitioner. Even though I am no longer able to procreate due to having had a hysterectomy because of endometriosis, I still had an open and honest conversation with my therapist regarding the subject. It was important for me as a human being with a uterus who loves and cares about others who have had or may need abortions to be on the same page with her. This topic also indicates a fundamental viewpoint regarding bodily autonomy, basic human rights, and the integrity of the patient-therapist relationship that influences every aspect of my healing from trauma, particularly sexual abuse. Knowing that my therapist is on my team and will fight for my humanity is critical for my continued trust in the therapeutic process, and it should be for you as well.

    Kateland Kelly

    Abortion Provider Shares Story of Helping Pregnant 12-Year-Old Girl

    “I want her to feel pain.” A lump formed in my throat; medical school never prepared me for this. Before I could formulate a response, he let go of his wife’s hand, crossed his arms, and spoke more forcefully through gritted teeth: “I want to know how to make her feel as much pain as possible so this never happens again.” “That’s not what’s going to happen today,” I started tentatively. The mother sniffed and interrupted wetly, “I never wanted this for her. We got pregnant when I was just 15…” Before she could continue, her husband cut her off, “Enough talk! Let’s do it. Right now. I want to watch.” When I think about my first abortion patient, the story haunts me — not because I guided her to the best choice for her, but because I watched as her father tried to use medical care as a tool for punishment. This tactic is not as uncommon as you might think. You may even be guilty if you’ve uttered the phrase, “If you don’t behave, you’ll get a shot.” Medicine and fear are intertwined for many, but when we talk about the reality of medicine, we can start to deconstruct superstitions and stigmas. This is especially important in terms of sexual education and health. When her parents scheduled the visit, they said they needed help addressing her interest in boys. They suspected she had a boyfriend that was sneaking into her room at night. They were a conservative Catholic family and in the state where this took place, the public school system did not offer sexual education. Children raised without access to comprehensive sexual education lack basic bodily understanding and are at risk for early pregnancy, sexually transmitted infections, and assault. I meet first with the family together, then I separate them for individual histories. In this case, the child, 12 years old, refused to speak in front of her father. She was obviously afraid of him; she was suffering. In my office, she admitted she had a boyfriend, a 12-year-old from her class, and that his older brother had been helping the boy into her room at night. When I asked her if she has ever had sex, she wrinkled her nose and shook her head. I asked her if she knew what I meant by that question. She admitted that she didn’t really know what sex was but they had “definitely never done it because I always keep my clothes on.” The conversation then turned to menstruation. She had menarche (first period) only three months earlier but had not had another bleeding episode since. As soon as I started that line of questioning, I knew where it was going; I just didn’t anticipate how the father wanted to make it end. As I gently informed her that she was pregnant, she kept asking if she could just go home. She promised she wouldn’t talk to the boy anymore. She didn’t understand why everyone was so upset. When asked if she wanted to be a mom or have a baby right now she wondered out loud, “Why would I want that?” This case was complicated; but then again, every abortion case is complicated. My heart broke as I informed her that because she was under the age of 15, the Department of Child and Family Services needed to get involved. Frankly, even if the child wasn’t pregnant, the way her father said he wanted to watch her feel pain set off red flags. She wasn’t safe in that home. It was as if she were a dog that needed to be beaten into submission for getting knocked up by the neighborhood stray. Truly, the way he spoke about his daughter’s reproductive circumstances had about as much respect as a cattle farmer discussing breeding. His daughter was a creature in a pen and in that moment, I knew my job was to protect her as a living person, not as an incubator. The Department of Child and Family Services took over that evening and she was referred to the closest high-risk OB/GYN. We determined she was approximately six weeks pregnant and would qualify for a medical abortion. Repeatedly and consistently, she verbalized she did not want to be pregnant, she did not want to have a child, and she chose her life. She wanted to stay a kid. The sanctity of the provider/patient relationship is why she was able to access the medical care she needed. At our follow-up, she was depressed because her parents had taken away her phone and she could not talk to the boy anymore. After everything she experienced, she still demonstrated a lack of bodily understanding that can be directly traced to the intentional prevention of sexual education. If she had been taught that you could get pregnant without taking your clothes off, perhaps this entire case would have been avoided. While her father was advocating for “the most painful possible way” to deal with her circumstances, his reaction highlights just how dangerous it is for uninformed adults to be making decisions in medicine instead of investing in education. Her father had no understanding of maternal/fetal medicine, but he knew he wanted her to feel pain, so he was advocating for a surgical abortion. Medical abortion is the combination of an antiprogesterone (mifepristone) and a prostaglandin (misoprostol) and can be used in pregnancies up to 11 weeks gestation. This combination of medication induces a shedding of the endometrium and any attached cells, and the effects are heavy bleeding, nausea, vomiting, and cramping. While not pleasant, it does not carry the risks of surgical abortions which are indicated in later-term pregnancies. A surgical abortion would have been unnecessary and cruel, but that’s exactly what her father wanted and he wanted to watch. He wanted to punish her for his mistakes. Rather than break the cycle of early pregnancy that he and his wife experienced as 15-year-olds, they chose not to teach their children about sex until one was already pregnant. There was a lack of trust in that family. No one talked to each other until they talked to me. I know that every conversation I have with my patients is dependent on that sacred trust, but patients lose that confidence if they are not assured that the provider is working on their behalf. Medical providers cannot practice medicine when men meddle without so much as a basic understanding of science. Ten years ago, we had the autonomy to help her make the right decision for her. Today, we don’t. I don’t know what will happen next in clinics across the United States in a post-Roe v. Wade climate. I do know that when we weaponize medicine, the most vulnerable in our society suffer and it will be the children that are born into this world that pay the price. Prevention starts with education and there is no place for stigma in medicine. Just like any other medical procedure, it is time we start sharing our stories about reproductive health, because if we don’t, we will continue to suffer the little children.

    The Mental Health Impact of the Supreme Court's Roe v. Wade Reversal

    This past Friday, the Supreme Court made the decision to overturn Roe v. Wade; the constitutional right to an abortion which was established nearly 50 years ago. This ruling will make it so each state has the freedom to decide whether to restrict or ban abortion, as opposed to it being federally protected, which it has been since 1973. Thirteen states have already passed so-called trigger laws to automatically outlaw abortion in the aftermath of the ruling, and many more states are likely to follow suit. The decision to reverse abortion rights has been met with both triumph and anger. On Friday, thousands of demonstrators formed across the country. An array of individuals with conflicting stances on the decision clashed in city streets as they celebrated or protested the Supreme Court ruling. This ruling is undoubtedly going to further fuel the political divide in this country, with polarized news outlets chomping at the bit to weave it into their biased narratives. Oh, what a time to be alive. If the constant discussion about the overturning of Roe v. Wade is leaving you mentally and emotionally drained, you are not alone. The mental and emotional health of many Americans has been in a state of decline for the past 2+ years during the COVID-19 pandemic, and the new ruling has the potential to only worsen it. In their statement, the APA expressed “deep concern and profound disappointment” regarding the Supreme Court’s decision, citing decades of research on how the denial of abortion can negatively impact one’s mental health. Restricting or banning abortion will undoubtedly increase emotional, physical, psychological, and financial stress for anyone with the ability to become pregnant. It also has the potential to increase the severity of existing mental health conditions and leaves one susceptible to the emergence of new conditions. To make matters worse, government funding and resources for mental health care are nominal at best. While there will continue to be access to abortions in about half the states in the country, the ability to travel to these states is not feasible for all individuals. Many populations in need of abortion services do not have the means or the resources to do so. The division between socioeconomic classes will be even more pronounced, which is just another factor that will contribute to poor mental health. Programs such as Elevated Access can help individuals access abortion in legal states, and need your support. The uncertainty and stress regarding the future of reproductive rights are bound to push many people into psychological crises. Therefore, it is important to preemptively create a strategy to manage your mental health. A 10-step action plan can be found here. In need of an updated list of abortion resources, now that your current list may be null and void? Check out this list. Want to make a difference but don’t know where to start? Think about donating to local abortion funds or independent abortion clinics. And remember, you are not alone.

    Brittany Johnson

    Why Halsey Talking About Her Post-Miscarriage Abortion Was Lifesaving

    Ever since SCOTUS made their landmark (horrible, shitty, selfish, racist, ableist…the list goes on) decision to overturn Roe v. Wade, many celebrities and prominent figures have come out to speak about their experiences with abortion in relation to their health, and one of those figures is none other than Halsey. Halsey wrote an opinion piece for Vogue on their experience with abortion, and how it changed their life after three miscarriages, ultimately leading to a healthy birth for their 1-year-old son, Ender. “One of my miscarriages required ‘aftercare,’ a gentle way of saying that I would need an abortion, because my body could not terminate the pregnancy completely on its own and I would risk going into sepsis without medical intervention. During this procedure, I cried. I was afraid for myself and I was helpless. I was desperate to end the pregnancy that was threatening my life.” Due to the past miscarriages, Halsey prepared for the worst. They rewrote their will in their third trimester, saying that should their brain stop but their heart continue, they wanted their organs to be donated to help others. “How funny that while my own heart would amount to nothing more than a series of involuntary movements on an operating table, a beating heart in my womb could mean I couldn’t consent to saving my own life.” This experience only radicalized Halsey more on their abortion stance. It’s because of their past abortions they were able to have a healthy baby and give him life. “Every person deserves the right to choose when, if, and how they have this dangerous and life-altering experience. I will hold my son in one arm, and fight with all my might with the other.” Ever since Roe v. Wade was overturned, people haven’t shied away from vocalizing how despairingly upset they are, and how fearful they are for the future. Some of those voices belong to our very own Mighty community. In A Letter to Birth Moms Who Are Hurting After the Reversal of Roe v. Wade by Maya Lorde, she pens a few steps for birth moms who are distraught over SCOTUS’ decision: “ 1. Take a nap. You deserve it. There is no shame in it. 2. Surround yourself with like-minded people who are not in the adoption fog (aka think adoption has no negative consequences). 3. Journal just for you and contain it. 4. Write your feelings and share in safe groups on social media and elsewhere. 5. Segregate your social media into spaces that are safe for now. 6. Write your child a letter. (I set up an email for my child and I periodically send her emails that she can see when she is older.) 7. Share with your family or social network about your real experience around adoption. It is the Each One, Teach One model. You may successfully change some minds. 8. Do advocacy such as make a TikTok video about your experience, start a blog, work in your state to change the adoption laws, support abortion laws, educate others about the risk of adoption and the true experience, hold adoption agencies accountable, give money to adoptee groups, vote. 9. Seek out adoption-competent therapy (not a clinician in the adoption fog). If you do not have the financial access, seek out birth mom support groups. If there is not one in your area now, many of them are virtual so you can attend from anywhere in the country. You can take your power back. Adoption does not have to make us victims. We do not have to remain silent (but we can if we need to for now). There is significant stigma, and it looks like it is up to us to change the narrative.” You aren’t alone if you’re angry, fearful, depressed, and/or anxious from the current news cycle. Just as Maya added, there are steps you can take to protect yourself to the best of your ability, such as downloading menstrual tracking printables versus using menstrual tracking apps. Halsey proves abortions save lives (as if we didn’t already know that), and I’m praying that our rights will be defended so they can continue to do so.

    Jenny Coffey

    Reflecting on the Roe v. Wade Reversal on the 4th of July

    I had nothing to celebrate this July 4th. It used to be my favorite holiday. My favorite years were driving the ambulance in the parade and having fun with the firefighters and police department. This time of year we were on duty, but able to enjoy it, and to have some laughs with each other. For the first time in my life, this holiday, the pride I used to feel, is just gone. Sometimes my brain feels numb, and other times I start to feel anxiety. It’s that sensation that you get right before a full-blown anxiety attack. My chest is tight, my neck feels full, and it becomes harder to take breaths. For the first time ever, I worry about having access to an IUD birth control device. I’ll tell you a secret. I haven’t had a cycle since 2013. When they told me that I had cancer again, I stopped having a cycle. My body literally just physiologically acted and shut down my long-broken oven. I would have loved to have been able to use it more than once. Are you surprised? Do you expect me to be against babies? The one thing I never got to do in EMS that I wanted to was “catch” a baby. I can’t tell you the number of heartbreaking miscarriages that I attended in my career. Back to the point. With the IUD, I have released a very low dose of hormone into my uterine walls. The use of this device has caused thinning of the walls, and decreasing in the adenomyosis that had occurred. One of my surgeons told me that his handprint stayed when he examined my “boggy” uterus during surgery. The amount of pain and suffering that I would go through at times, and the fact that I had already had cervical cancer, which cost me half of my cervix, left my reproductive organs far too broken. I need this for very real reasons. These laws are all ready to be written and enacted, to be introduced into states, and remove coverage for birth control such as IUDs. When I was in my 20s, I had polycystic ovaries, along with newly diagnosed endometriosis. The endo actually barred me from military service. I was in the hospital almost every month with ruptured cysts and horrific pain. I would internally bleed from the endo and fill the cul de sac with fluid from the ruptured cysts. The ones that didn’t rupture would move as I did, and bang into the insides of my body. The doctor put me on back-to-back pill packs. Yes, birth control pills, with the idea of preventing menstruation. I remember feeling humiliated, and so very small and dirty, when the pharmacist refused to fill the prescription. He said, “It goes against my religious beliefs.” He motioned for me to leave, as he waved my script back in my face in a rushed motion that I should take it from him, as if it would burn him if he held it any longer. I remember hiding “the pill” from the sight of others, worried about judgment even as I was wheeled out of work by an EMS crew with a ruptured ovarian cyst. I felt ashamed, as if my reproductive organs could be seen by others. It caused me to crumple to the floor in a fetal position. It felt like shards of glass trying to get out of my torso. Not only my abdomen, but my entire body revolted from the pain and tried to shut down. At least I didn’t puke, at least not at first. Let’s face it. I’ve never had it easy. I have fought against being sickly since I was a kid. All I seem to acquire these days are new diagnoses. The trouble with being chronically ill, especially with rare diseases, is there is never the achievement of a cure. The finality of being able to walk away from it all. It was hard enough when I didn’t have to worry about accessing the care that I needed to live. Now I have fear. The care that I have already sold my life to buy into gets harder and harder to access. Am I now on borrowed time? Will my access be harmed? I’ve talked about this before, from a different angle, most recently in my article, The Reality of Chronic Pain Care, on The Mighty. This year, I am a second-class citizen. I’ve long felt that way as is. I can’t access the same medical care that I gave. You think you have lived right until they can’t cure you. I have lost the right to have total control over my own body. It feels awful; damn, it feels unreal. Those in power claim to want to stop abortions, while simultaneously not investing in, but removing, birth control access, comprehensive free prenatal care, parental support, WIC, food stamps, housing, education, and so on. The far-right is working for more children to be born into an unsupported life of poverty. Can I tell you from personal experience that those people are assholes? Guess I just did. This is not politics as usual. This is stepping back in time, and women and people with a uterus are no longer equal. Forced pregnancy is disgusting and dirty. I still feel shocked. It feels like I am watching the birth of Gilead. In my freshman year of college, I read “The Handmaid’s Tale,” a work of fiction that now seems to be becoming real. This is the new America, and the birth of the underground railroad for women. That is what they have succeeded in creating. They have signed the death certificates in advance for countless women who will die by suicide, ingest poisons, and have backroom abortions. Most of those occur in private homes, typically affecting people of little means. Consistent with out-of-control religious patriarchy, the objective is clear — removing the right to abortion, access to birth control, and forcing procreation on women. None of this is hyperbole. This is real. Women shaming is already happening. I’ve seen so many social media posts with comments like, “keep your legs closed” and “don’t have sex outside of the bonds of matrimony.” I’m reminded of another Mighty writer, Seanín Hughes, who wrote, “In learning to become a woman, I learned our bodies are subject to social commentary, opinion, and judgment based on how successfully we strike the balance between prescribed function and aesthetic — and we remain at the mercy of those who have the power to tell us we are failing.” When we dress wrong, live wrong, or do something to cause sex to occur. The ability to feel, to enjoy intercourse without the intent to have children. We still fight against stigmas inflicted upon us and edicts we never signed on to follow, and are shamed for what our male counterparts are rewarded for. We are in a world that was on a great track to creating equality, one I took great pride in being a part of. Now, shamed and sad, I have lost my freedom, my Independence.

    How Roe v. Wade Reversal Affects Access to Autoimmune Treatments

    It’s essential we recognize the woman’s body as a whole, medical, human body. At conception, women may have autoimmune diseases, multiple sclerosis, cancer, depression, and a myriad of other physical and/or mental illnesses. The medications and treatment we receive as women, the choices we make about treatment based on what works, and personal beliefs belong to the patient and should remain a conversation between the doctor and the patient. Women have only been involved in most medical studies since 1986, and women make up 80-90% of individuals with autoimmune disorders. It’s no surprise then that the medical community lacks a comprehensive understanding of autoimmunity. Other women in the chronic illness community and I speak for hours about the walls we hit when trying to get diagnosed, being called hysterical, a hypochondriac, and told, “it’s just stress.” Given the fact that women have a higher tolerance for pain on average than men, one would hope a woman would be heard when she voices pain. A friend of mine with psoriatic arthritis had a rheumatologist who would not treat her with methotrexate until she had an IUD put in her uterus. For many autoimmune diseases, methotrexate is a first line of defense, and often an effective medication for combating arthritic symptoms. A fellow Mighty member wrote about her experience with a doctor in her story, What I Learned When a Doctor Put Her Bias About Medication Above My Needs, “ “What do you mean I have no other options? What about methotrexate?” She replied, “Eh, I don’t really like giving out that medication, because I had a 17-year-old girl who was on it and she got pregnant.” I am thankful I was able to get methotrexate. My rheumatologist informed me that if I plan to have a child, I should discontinue methotrexate during the time I am pregnant. I have no plans for kids, so I take methotrexate. I have lupus and psoriatic arthritis, and no biologic has been effective at treating either. I choose to take methotrexate, Otezla, and chloroquine because these are the medications that give me the most relief with the least awful side effects. We must understand that women’s bodies work as entire ecosystems — poorly-understood ecosystems. Thinking about our reproductive system as though it exists independent of the rest of a woman’s body leads to danger and harm. We see doctors already taking the liberty of making medical decisions for women based on the hypothetical that a woman could become pregnant, and entangling that hypothetical with the doctor’s personal views. Overturning Roe paves the way for a far deeper loss of medical choices, predictably in the chronic illness community. We must fight to ensure the care and treatment of women, and to enable continued research and respect for women’s bodies as medically important. This will lead to greater medical advancements as a whole, and will help protect the entire chronically ill community.

    Deleting Your Menstrual Cycle Tracking App? Try These Printables

    When I was younger, I used my wall calendar to track my menstrual cycles. And then my planner. Then eventually, I moved into a digital calendar, and so I also moved into a cycle-tracking app. On the long list of health diagnoses that impact my daily life, polycystic ovary syndrome (PCOS) ranks pretty high. Among other things, this means my cycles can be extremely irregular. Sometimes I’ll bleed for weeks, and other times I won’t see a cycle for months. Using a digital tracker felt like a weight off of my shoulders. It handled the math for me, calculating and recalculating my cycles, letting me know when a cycle might be coming, tracking how “overdue” I was (helpful for showing doctors), and was a light in the dark moments when my premenstrual dysphoric disorder (PMDD) kicked in and my brain told me awful things. I could open the app and say, “oh, I’m probably two days out.” But given the Supreme Court decision to overturn Roe v. Wade, the new six-week “heartbeat” law in my state (with a statewide ban being debated), and the writing that’s been on the wall – it’s time for me to delete the apps. Past time, really. When the draft leaked, I looked for alternatives. I tried a few, including one that marketed itself really well ahead of the Roe ruling. T he idea of losing all of this historic data from the app I’ve been using for the last (almost) decade infuriates me, and the idea of transferring it to paper feels overwhelming. Ultimately, the best choice for me at this moment is to go back to pen and paper, but the idea of losing all of this historic data from the app I’ve been using for the last (almost) decade infuriates me, and the idea of transferring it to paper feels overwhelming. So, I made a list of what I needed to track, how I wanted to track it, and my process for making this data transfer happen. I know I’m not the only person feeling this way, which is why I’m sharing. Worth noting: cycle-tracking apps are not the only way your data can be tracked and used against you. Taking the step to delete cycle-tracking apps is only one step , and does not fully protect your information from hostile state governments. I made a printable menstrual cycle tracker – it’s minimal but functional – and you can download it below. You don’t have to give us your email or tell us any information about yourself, and we won’t track who clicks into or downloads it. Just click the link below and download. Share it with your friends if you want. It’s a PDF so you can use it in GoodNotes, or print it off and tuck it away. DOWNLOAD THE FREE MIGHTY CYCLE-TRACKING PRINTABLE How to Transfer and Delete Your Cycle-Tracking Data Print off (or duplicate in GoodNotes) one page for every year of historic data you want to save. Record the data from your app(s) to the printable. Probably double-check your work. Tuck the pages away somewhere. Delete your data from the app. Delete any backups in the app. Depending on the app you’ve been using and its terms, email and ask for all your data to be deleted from their servers, mailing lists, sales lists, etc. Delete the app itself. Other Options for Purchase From Small Businesses There are also lots of beautiful cycle trackers available for purchase on Etsy. There are single page trackers, packets, and even some full books. Some have gendered language, but many are neutral. Here are just a handful of options: Menstrual Period Tracker — 3.75” x 6.75” Personal Planner inserts by SimpleandTrendyCo Single-Page Annual Tracker by LiveMinimalPlanners Monthly Single-Page Tracker by WriteIdeaDesign Monthly & Yearly Pages by RunawayShea Menstrual Calendar Journal by TheKapuShop ‘Moonblood’ Tracker: Track With the Lunar Cycles by TheWanderingMoonCo And if you’re into stickers and other journaling supplies, you might like these mini blood drop stickers, these stickers to indicate flow, or maybe these stickers that have symptoms too. You can also use one of those pretty notebooks you’ve saved for the “perfect” time. Oh, just me?

    Samantha Yonts

    Pregnancy With a Chronic Illness Made Me Even More Pro-Choice

    I already felt trapped in my body due to my disabilities. I’ve felt like a caged bird for years yearning to fly, to feel the wind in my wings and soar to great heights. I had dreams all my life that I could fly. Now the cage is smaller. The cage is close to being so unbelievably small that I’m crushed. My wings will be broken and I’ll never ever be able to fly. I’m a bird that happens to have a uterus. I’m a bird that happens to be pansexual and bigender. Soon they’ll say that’s wrong as well. I have no rights in my prison they call a cage. I’m scared and just want to fly, but where I live that’s not allowed. Where I live I can’t sing my song and I can’t be free. I’m a bird that’s afraid of laying eggs. What if they don’t make it? Am I going to jail because they think I committed a crime? What happens if I’m egg-bound? Are they just going to let me die? I took very good care of my eggs and built my nest right, but they won’t believe me. What happens if I lay successful eggs and there are no worms? They can’t keep them in stock. Maybe if I actually was a bird they’d care more. Animals have more rights than I do as a human. I’d have more rights dead than alive as an organ donor. I have the right to purchase a firearm, but no rights to my body… I almost died giving birth the first time. What if I have complications early on if I try again? How pro-life would it be to leave a child without their mother because I died being pregnant with their sibling? Because saving my life would be considered an abortion. I’m not having any more children unless things change. As much as it hurts, I can’t do that. The world is a scary place to even consider it. I have to think about the kids I have now. My dreams of having one more have been crushed by a flawed system. There is no American dream! It’s an American nightmare! I became more pro-choice after pregnancy and childbirth. No one should have to go through that if they don’t want to or they’re not ready. I almost lost my baby, I almost lost my own life, I lost teeth, I grew a weird growth on the back of my head that always bled, and I lost an organ (gallbladder). I soaked 36 towels in my blood (from placenta abruption due to pregnancy hypertension) during my emergency C-section. Pregnancy and childbirth are hell on the body. No one should be forced to carry the weight of what that brings. No one should be forced to carry a child! We cannot lose the right to safe abortion! We know abortion will still happen regardless and we’ve lost enough lives to unsafe ones. I didn’t give birth so my child can grow up and not have rights to her own body! I will continue to fight for her, for myself, and for those with a uterus everywhere. We cannot be quiet. Silence is violence and we’ve had and seen enough of that! We need to stand up and fight for the rights we deserve. We haven’t come this far to lose! Be loud, be active, be angry! We are at war and we need to keep fighting!