Let me start with a story about a family friend of mine. Alex (I won’t use her real name for confidentiality reasons) was a pro-life activist—she opposed abortions and thought that it was an unacceptable reproductive option. Alongside several pro-life supporters, she never accepted women who had them, sometimes even openly shaming the ones who took part in the practice. She never took the time to understand why a woman would have to make the difficult choice to have an abortion. In her mind, only those with an ego large enough to believe they could control life and death went through with the procedure. That was until Alex found out that she was pregnant, despite taking birth control pills to avoid pregnancy. She did not have the money to start a family. She knew it was not the right time to have a child: not for her or the man she was with. And, Alex knew that if she brought a child into this world, it would not have a good life.

All of a sudden, the tables were turned. Alex finally understood why women had abortions. She understood how important it was for women to have the ability to choose what to do with their own bodies. Eventually, she decided to be “Pro-Choice” —believing that women should have the choice to choose what they do with their bodies—and this includes supporting the right to have an abortion. Today, she continues to advocate for a woman’s right to choose what to do with her own body. There is nothing wrong with women choosing to keep their unborn babies or not, and there is also nothing wrong with choosing to go through with an abortion.

Unfortunately, Alex’s story is not uncommon. Both men and women who were previously pro-life often are only able to understand the Pro-Choice stance after experiencing difficult  moments in their life—such as a pregnancy they cannot support. And, shaming women for having abortions is not new. The truth is, abortion has been stigmatized by those who view it as an undesirable procedure for ages. Even this week, there were protesters outside of Choices, screaming into the ears of women who walked into the clinic.Week after week, we are plagued with fake bad reviews on Google and Yelp from Pro-Life radicals who believe that women are not intelligent enough to make their own choices.

I hope that one day, abortion rights will be secured for women so that they will always have the ability to choose how to live their own lives.

This week, partially because I am premed, I decided to research how hospitals, including Choices Women’s Medical Center (my placement), are dealing with the COVID-19 pandemic. I wanted to understand how the outbreak would change the ways that patients interact with doctors. The biggest change I found was the increasing use of the telehealth system: a way in which patients can call in using video to schedule an appointment. I decided to interview a few people who are part of the clinic and do my own internet research about the pros/cons of a telehealth system.

Although Choices in-office care was open during the pandemic, they began to promote and expand their telehealth services. Though founded in 1971, Choices led in the development of online care for women’s health since 2016. According to one of my mentors, Choices Tele-Health was a way for the clinic to offer the same high-quality healthcare as their in-office visits while complying with social distancing guidelines. From the comfort and safety of a patient’s own home, Telehealth is another way to talk to healthcare professionals.

But wouldn’t online doctor appointments compromise quality? Apparently not, especially if the appointment requires little more than talking. Essentially, the same conversations occur in an in-office and telehealth visit: the only difference is that one is virtual. Patients can share a private, personal video meeting with one of Choices’ healthcare professionals or licensed social workers who will be able to address their specific concerns and answer any questions they may have.

Additionally, what’s cool about telehealth is that it allows patients to meet from anywhere! Telehealth allows flexibility with scheduling—a lunch break, after dinner, or on the drive to work. And, because the appointment is virtual, patients will not only save time and money, but it will limit the time they are are out of their home during this pandemic.

According to another mentor, “from counseling to a range of essential GYN visits including birth control, follow-ups, lab results, Full Pre-Natal Care, nutrition, and general options counseling, Choices ensures that their patients can privately and safely access our health professionals through our telehealth network”.

Now comes the confusing part: how does a patient tell the difference if they should have an in-person appointment or a telehealth appointment?  If your appointment requires minimal contact, then telehealth may be the right option. Examples include: follow up visits, consultations, and general questions about sickness symptoms, etc. However, if someone likely requires testing or in-office procedures, then they should schedule an in-office visit. According to their website, Choices also made it easy to shift between a virtual visit and an in-office visit if necessary. That’s so if a patient is not sure if you require any in-office procedures, they can also schedule a telehealth appointment and talk to their doctor about it first. That way, if they do require in-office testing or procedures, their doctor can transfer them to an in-office visit during their meeting, which can make their in-office visits shorter and their wait times less!

So, has COVID-19 permanently changed the way patients interact with doctors? The answer is a resounding YES! Now that telehealth has been popularized and streamlined, I believe that more and more doctor’s visits will be online. Be it annual appointments, follow-ups for procedures, or even just the question about the common cold, telehealth is using technology to make strides into the future.

This week, my placement, Choices Women’s Medical Center, wanted me to do research and help write an article about systemic racism in US healthcare and how it directly causes differences in rates of mortality and morbidity. They asked me to do this in light of the Black Lives Matter movement. While I always knew that systemic racism impacted the treatment of patients by doctors and staff, I was absolutely appalled by how huge of a difference a patient’s race can have on their likelihood to live or die from treatable illness. Here is just a fraction of what I learned:

“Imagine this: You go to the doctor and routinely feel unseen, unheard, misunderstood. Sometimes you fear you’ve been misdiagnosed. But your concerns are brushed off. You aren’t apprised of the full range of treatment options—the doctor seems to assume they don’t apply to you, or that you can’t take in all the information. Your local hospital is underfunded, the equipment outdated, frequently nonfunctional. You’re denied pain meds. You’re handled brusquely. Staff openly question your ability to pay.” (Emma Stallings, Oprah Magazine).

Dr. Monique Teller also quotes the experience of one of her black female patients in the emergency room: “They treated me like I was trying to play them, like I was just trying to get pain meds out of them. They didn’t try to make any diagnosis or help me at all. They couldn’t get rid of me fast enough”. Her patient was convinced that she was treated poorly because she was black.

And she was probably right. Not every black woman has had experiences like these, but it is clear that they are disappointingly familiar to the vast majority. According to a study done by the CDC in 2011, black women are three to four times more likely than white women to die from complications during pregnancy or childbirth. In fact, they made up 42.8% of the deaths resulting from pregnancy or childbirth in comparison to white women, who only made up 12.8% of this population.

It is undeniable that the American healthcare system is beset with inequalities that disproportionately impact people of color, especially black people. These inequalities contribute to uneven access to services, gaps in health insurance coverage, and poorer health outcomes amongst certain populations. Doctors may take an oath to treat all patients equally, and while most are not explicitly racist, they operate within a system that is inherently racist.

“Black women are treated differently because of the color of their skin,” said psychologist Fleda Jackson in the Fusion documentary The Naked Truth: Death by Delivery. “Many don’t know their rights and suffer abuses, and they don’t have insurance. And they also suffer from sexism. They are Black and they are women. There is no rest for them in these circumstances.”

We cannot sit idly by and allow this horrible injustice to continue happening. One fact is clear: the United States healthcare system must change. In order to fight racism and discrimination, we must name, recognize, and fully understand the attitudes and actions that put the lives of black people in danger, especially in the healthcare industry. We need to be able to somehow manage bigotry safely and educate ourselves and others. We need to practice and model tolerance, open-mindedness, peace, and respect for one another.

After all, the struggles of one marginalized community are struggles of all of us. Black Lives Matter.

This week, I actually wanted to digress a little bit from my work at Choices Women’s Medical Center and talk about something that’s been bugging the heck out of me.

When the COVID-19 pandemic struck, school was cancelled nationwide. At an individual level, the choices many families made to cope with the shift makes sense economically. What do children need? Taking care of. What do older people (grandparents) need? Taking care of. What do patients fallen ill with the virus need? Taking care of. Care. And, all this care—unpaid emotional labor—WILL fall most heavily on women because of the current structure of society. But, according to Clare Wenham, an assistant professor of Global-health policy in London, it’s not just about social norms. It’s also about practicality: “Who is paid less? Who has the flexibility?”.

It all dates back to a structure created as early as the 1950s—something which Erin Hatton talks about in her book, The Temp Economy. Hatton describes how temp work strengthened gender stereotypes. Because temp work is paid too little to be considered a living wage, women were further established as a secondary earner. Thus, the dominant image of temp work promoted the image of the male “breadwinner”, further confining women in the domestic sphere. Additionally, by defining women as only “secondary earners”, employers justified paying women lower wages.

What is sad is that, according to the British government, 40% of employed women still only work part-time, compared to only 13% of men. The disparity that Hatton described from the 1950s STILL exists. Women are STILL considered socially to be secondary earners.

But even if women leave their jobs to go home, will they be appreciated for their sacrifice? The answer is NO, all thanks to the historic undervaluation of domestic labor. Arlie Russel Hochschild analyzed the wages of care workers such as nurses, babysitters, and other care facilities in 2002, describing how “the unpaid work of raising a child revealed the abidingly low value of care work generally—and further lowered it”. Hochschild suggests that because care work was not paid for most of human history, it lost its value.

Let’s apply this analysis to the pandemic. Because women are more likely to be the lower earners, their jobs are naturally considered a lower priority when disruptions come along. If Hochschild’s analysis is correct, it means that as women during the pandemic are forced to quit their jobs and lose their ability to earn money, the classification of their “caring work” as “nonwork” and themselves as “dependent” in their relationships with their husbands will grow stronger.

Thus, the pandemic is going to reinforce prehistoric, dinosaur-age societal roles. And this particular disruption could last months, rather than weeks. Some women’s lifetime earnings will never recover. Some fathers will undoubtedly step up, but that won’t be universal. Women’s independence WILL be a silent victim of the pandemic.