“Woman must have her freedom, the fundamental freedom of choosing whether or not she will be a mother and how many children she will have. Regardless of what man’s attitude may be, that problem is hers — and before it can be his, it is hers alone. She goes through the vale of death alone, each time a babe is born. As it is the right neither of man nor the state to coerce her into this ordeal, so it is her right to decide whether she will endure it.”
― Margaret Sanger, Woman and the New Race
My old job did a horrible job at supporting women’s health. There, I said it. No real maternity leave (unless you count 12 weeks without pay, after which time your job is hypothetically up for grabs and much relies on the goodwill of your department), no day care (there is a single care area, but it is a research facility and not open to public enrollment), and frankly less than impressive health care options.
I have my theories about this, but primarily I think it’s because it’s a private religious school that’s part of a traditional gender essentialist cultural. Women with kids should be at home with those kids, goes the thinking. Granted I certainly I never heard anyone at the university say this in an official HR capacity, but I heard it everywhere (including some classes) unofficially, even from administrators of my own department. Let me be clear, I do not believe for one second that the policy and procedural edicts on the subject were the result of some cabal of men evilly stroking cats and scheming in a dark room somewhere, but I do think that this idea of prescribed gender roles passively plays a role in making assumptions about what working women do or do not need long term.
I’m not going to get into the arguments for or against this cultural set up now, except to say that for a school that emphasized family values, I often wondered why I saw so many policies and procedures – and cultural mores – that made it hard for women (employees and students alike) to have one, because that’s a rant for another day. What really bothered me personally was the issue of birth control.
Yes, my birth control was theoretically covered by my work insurance plan. In practice, however, it turned out to be cheaper for me in the long run to go through Planned Parenthood for my annual exams and prescriptions. That is ridiculous. I often wondered what was the point of my healthcare plan if the main thing I used it for besides dentistry (being otherwise a pretty healthy person) turned out to be more financially heavy than services outside its administrative scope. And believe me, Planned Parenthood was not popular or commonly marketed as an option in this state!
But the real challenge came when I quit that job in preparation for our London move. I needed a supply of several months to get me through the summer, the move, the settling in, and the setting up of our new health plan in Britain – we’re covered by the NHS but opted for additional coverage as part of Jeff’s work benefits package. Planned Parenthood could only give me 2-3 month of a prescription at a time, and my GP couldn’t write me a prescription that could account for my change of employment status, since my insurance disappeared with my job. My GP was a great doctor who took them time to listen to my concerns and ultimately wrote me a full year’s prescription and worked with the pharmacy to fill it, since they also normally dispense it in smaller quantities. But it was entirely out of pocket for me and cost nearly $400 to do so – a bit more than a $1 a day to remain child free by choice.
Fast forward to London. When down to my last month of birth control, I make an appointment with the doctor’s office I’ve registered at (coincidentally a 7 minute walk from our flat). My stats and measurements are taken, my health history is reviewed, my current prescription is examined to verify they carry the same or a similar drug, a new prescription is written. The whole process takes 10 minutes. Four days ago I walked to the adjacent pharmacy and filled it, getting two months of BC. It is not as attractively or complexly packaged as what I got in the States, but the dosages are identical.
It cost me nothing.
I don’t pretend that socialized medicine is without consequences, particularly for a country as large and divided as the US. But I grew up in socialized medical care – by which I mean… the system that treats the military and government servicemen and women of the country. It too had some major drawbacks (witness a large scar on one arm when having skin biopsied vs the nearly invisible one I got for the same treatment in private care), but when run properly it works. Astonishingly well. I’m for more of it, particularly more that treats women’s health as an integral part of the system, since we’re 51% of the population, instead of a specialty field.
Discuss.
– My friend Heidi documents a less than stellar experience from her Danish doctor. Any other expats have stories to share, good and bad?
– John Green talks about healthcare costs on the vlogbrothers channel, worth a view even if you disagree vehemently.
– A post laying out the pros/cons of universal healthcare and comparing it in the US to other nations
Small Dog Syndrome 
Great post! Living in the US, I paid a $10 monthly copay for birth control, but I was fed up with forgetting daily pills fairly often. I asked my insurance about coverage for Nuvaring – $25 a month, which as a student was pretty expensive. So I asked about IUD options (Mirena). It was totally covered. 2 years later and I’m SO happy not having to think about it! Now living in France, all contraception options are fully covered.
Thanks for piping in! I’m interested in IUDs as an option but the pill works for me in the meantime because I’m hyper diligent about taking it.
If you’re ever considering, I’d be happy to answer any questions you may have!
Ah, birth control. One of my favorite units in my women’s health class back in the day. 🙂 I distinctly remember sitting in the testing center taking a test that quizzed me in-depth on what hormones did what through the month and how birth control changed it. I feel I’ve got a pretty solid grasp on it all.
I was always confused with my insurance. Sometimes my pills would cost me 25 bucks a month, other times it was free. A bit of a mystery really (probably one I should have looked into more but oh well).
When I was moving to China, I did the same as you and tried to get a year’s supply of birth control. Unfortunately, I had moved away from my doctor in Florida and was in California. I had three weeks of notice that we were moving to China, during which time I had a zillion other things to do. I opted to forgo another doctor’s appointment, and instead called my old doctor and begged for a year’s prescription. They said they couldn’t give me more than a three month supply without being seen again. I told them that was fine. I still had a few months left on my old prescription so I picked those all up and then had to go back another three times to the pharmacy before they would dispense the new prescription to me (some weird rule about the right number of days being between prescriptions). They also told me that birth control is over the counter in China so it would be easy for me to get more (which I knew would be completely wrong- it’s over the counter but that does NOT mean it was easy by any means. Try reading medical descriptions in Chinese and you’ll begin to see my trouble).
I recently ran out of my American birth control and opted to get more down in Hong Kong, which tends to have better medical care than mainland China. It took a bit of research to figure out a pharmacy there, but once I found one, it was as easy as walking in and asking for it (well, that plus showing them my birth control packet because they didn’t understand my question – luckily, they knew what the little blister pack was for). I picked one pretty much at random, hoping that it was compatible with my old medicine and that it would all switch over just fine. I guess we’ll know in about nine months if it’s working. 😉 Each month’s supply cost about $17.
I must say it was super nice not having to go to the doctor to get those little pills. I guess when you’re a country that only allows couples to have one child you make sure it’s easy to get birth control. 🙂
And an interesting side note about that – once you have a child in China, the woman is required to have an IUD inserted. They’re still using metal IUD’s here – the US has upgraded to nicer plastic ones that don’t cause damage like the metal ones do. You can only have the IUD taken out for severe medical issues – otherwise, it’s in for life. Talk about women’s choice, eh?
Ah yes, the science is easy, the business is not 😉
I was hoping you’d weigh in with the Chinese system and experience! It’s socially, politically, and culturally fascinating to me that however society tries to put a lock on individuals’ sex organs (and every society does in some way or another), some still try or feel obligated to lock down the entire person attached to them. Women, far more than men, are often seen as extensions of their reproductive organs, rather than the other, and I believe correct, way round.
Any thoughts, since you’re there on the ground, on how much longer China might be able to enforce their one child policy?
Ugh don’t even get me started on how I found out the hard way that they wouldn’t even pay for my 5 minute visit to the doctor to get my b/c prescription refilled. As much as I hated the $60/month out of pocket for my expensive b/c I figured it was a lot less expensive than having a baby. (Trust me, now I know how much that costs too!) Also fun fact: they won’t cover a woman’s birth control prescription, but they will cover a man’s prescription for Viagra. Ridiculous.
Preach.
The Viagra vs. BC aspect makes me furious and tired. It as good as says that men’s sexual satisfaction outranks women’s actual health. I can’t even begin to list the things wrong with that statement.
Pray do let Incendiary Mondays become a thing.
Chip’s uncomplicated, vaginal delivery on the student version of that insurance felt like actual robbery. It was madness. I can’t stomach what the bill might have been if we’d needed more interventions. It’s no wonder so many of my fertile friends went the Medicaid route.
Mirena is the best form of family planning I’ve tried, bar none. No periods? Yes, please!
I’m considering Incendiary Mondays being a thing, I feel like I’ve been too safe in this little corner of the blogosphere!
Your example backs me up. “Family Friendly” policies and services, my eye! For a school that produces so many babies, our alma mater has a long way to go about getting those babies into the world in a way that neither bankrupts parents, nor makes them reliant upon the state (Be Prepared, self reliance and all that?).