Dr. Kristyn Brandi on What's Really Happening in Reproductive Care Right Now
What happens when your doctor wants to help—but the law says they can’t?
In this episode of ROAR, host Danielle Davies talks with Dr. Kristyn Brandi—OB-GYN, abortion provider, and reproductive justice advocate—about what reproductive care in America really looks like today.
From doctors calling lawyers before treating patients to fake clinics posing as medical centers, this candid conversation exposes the harsh realities behind the headlines—and what it means for women’s health and freedom.
💬 In this episode, you’ll learn
• The difference between reproductive health, rights, and justice
• How abortion bans impact miscarriage care and maternal health
• What contraceptive coercion actually looks like
• How to advocate for yourself (or your kids) in a broken system
• Real-world ways to support reproductive freedom—without running for office
🩺 This isn’t a debate. It’s the truth. And it matters.
To Learn More
Ryan Program
New Jersey Abortion Access Fund:
Abortion Doulas:
Abortion Care Network:
The Comstock Act:
Also Mentioned
Article featuring Dr. Brandi discussing false abortion centers in New Jersey:
Looking for Jane: Fictional account of the real Jane Network
To get in touch with or follow Dr. Brandi
Listen to ROAR with Danielle Davies: Women, Culture & Impact on Apple Podcasts, Spotify, YouTube, or wherever you get your podcasts. New conversations every Tuesday.
Full Transcript
This transcript was generated automatically and lightly cleaned up. It may contain small errors.
Hey, I'm Danielle Davies and you're listening to Roar, a show that amplifies the voices of women breaking barriers, leading change, and making real impact. Keep listening for bold ideas and stories that inspire you to find your voice and make some noise. Takeback Trust is a directto patient education and empowerment platform that helps people navigate and access reproductive health care in an increasingly restrictive landscape. Through clear, actionable resources, Takeback Trust equips individuals with the knowledge and tools they need to advocate for their rights and get the care they deserve, no matter the political climate. Hi, I'm Danielle Davies, the host of the ROAR podcast.
And today we're speaking to Dr. Kristyn Brandi. Kristyn's a gynecologist, abortion provider, and reproductive justice advocate with research expertise in contraceptive coercion and patient centered care. Dr. Brandy serves as a consultant for anti-opression work and medical education, including with the National Orion program.
She identifies as a queer Latina woman and catmom. And I just want to say at the outset that today happens to be the anniversary of Row. while the state of access to reproductive rights resources may change by the time this episode airs, the themes and challenges we discuss will remain critically important. So we'll get started. welcome Kristen.
Thanks so much for having me. Thank you for being here. I'm excited. And it's interesting I'm speaking to somebody in the same state which is nice because we're both as awake as each other. So, before we dig into everything, could we talk a little bit about your bio?
Could you unpack the concept of reproductive justice and how it differs from reproductive rights, just so our audience is aware a little bit. Absolutely. And I think that's something that comes up quite a bit. So, I'm glad to be able to explain the difference. and I'll add in their reproductive health because I think that's something that I'm also part of.
So, reproductive health is the work that I do every day as an OB/GYN, taking care of patients. That also includes things like public health efforts to try to get information out there about reproductive issues. Reproductive rights is the stuff that you see kind of on TV in politics, the work where we're trying to fight for legal rights for things like abortion, but also other stuff like contraception, birthing care, gender affirming care, I kind of lump in there as well. okay and then reproductive justice is a bigger concept I think it's generally defined as people's ability as a justice issue but also as a human right to be able to decide to get pregnant to not become pregnant and to parent in safe and sustainable communities and the way I think about that as an OBGYn is that my patients come to me for all kinds of different things they come for a papsmear they come for an abortion and they come for prenatal care. It's not just like the test that I'll do or the ultrasound that I'll perform that impacts their health, but things like do they have access to food?
Do they have access to housing? is there the ability to get to my hospital or my clinic? do they have a safe environment for them to decide to parent? are they incarcerated? All these other things that impact people's abilities to decide if they want to be pregnant.
and can they parent if they choose to parent? So, it's a broader concept that brings in a lot of issues from other spaces around social justice issues and human rights issues. It's interesting and this is not where I was going to go next, but it's interesting that you know that you talk about that kind of whole holistic approach and not to be overly political and lean on the reproductive rights aspect of it, but when people seem to be very staunchly anti-abortion, a lot of the you know the what comes back to them is but you're advocating pro-life. However, what kind of life is it? they have to also look at all of these other contributing factors.
So, it's interesting. So, now thank you for explaining that because it really helps me as well. And can you also tell me just so I have your background a little bit more how the national Ryan program is tied to that? Sure. And so I think one of the important pieces that we're training the next generation of providers to do this work and so the Ryan program nationwide helps OBGYN residencies establish abortion training specifically.
many people may not know that all objeans are not necessarily trained in abortion services. it's something that is required that there's some experience, but that experience could be a lecture or they could read a chapter in a book, but many may not have hands-on experience of how do you perform the procedures, how do you provide the medications, what are contraindications for medicines, how do you manage complications and so the Ryan program was established to help OBGYn's residency programs, which are the training programs you do after med school, helps them learn how to get the resources to be able to create rotations So residents can learn how to provide this care so we can actually have abortion providers in the future. So critical work to help the next generation. Absolutely. And are you seeing any kind of I know that some doctors are actually leaving states at this point so that they can provide care in states where they can do their work.
Are you seeing a decline in participation in the Ryan program or has there been, you know, the reverse of that where people really want to know so that they can provide access to care where it's needed? I'm just curious. Yeah, I think it's you even have that information. Yeah, I think it's like a mix of things right now. So, on one hand, because abortion's become illegal or very restricted in some places, places that may have had training no longer have that training.
So, the Ryan program and other places are trying to scramble together and figure out how are we going to train hundreds of OBGYn and other providers because it's not just OBGYn that are providing this care. How are we going to figure out how to get them training? And so a lot of the work's been creating out ofstate training programs so that way a trainee from Texas can come to a place like mine in New Jersey and be able to get a couple weeks of training hands-on to learn those skills even though they can't actually do them in their home state. and I think actually for some places people are now fearful to be able to train folks. So they don't know what they can say.
Can they give a lecture? Can they talk about hypotheticals of how to train people? whereas other places I think that were kind of lukewarm around abortion, now that it's restricted or now there's talks about it being restricted, people I think are more becoming advocates of yeah, actually we need our trainees to learn how to do this, especially if our trainees in the next state over can't do this care. So some of it's been used as fuel to kind of help training programs get stronger. but unfortunately I think most of it is that people just can't train anymore and are having to figure out where else they can go.
That's really scary. and we're gonna we're gonna come back to that, but I want to make sure I've got your history first. So, can you just tell us a little bit more? I know you're in New Jersey like me. Can you tell us a little bit more about your journey to becoming a gynecologist, abortion provider, and reproductive justice advocate?
Like what in, you know, what inspired you to do this? Sure. I'll start with an OBGYn because that's kind of the first thing I had to decide. when I went to med school, I knew I wanted to help people. I was really interested in science.
But I also kind of lived this separate life of someone that was very interested in social justice issues like I was very into repro rights u into LGBTQ rights and I figured when I became a doctor I just had to kind of put that aside and go you know be a serious doctor and do all that serious medical stuff and ignore all the other things I cared about. And I found that OBGN was a good combination of a lot of the science and this interesting things I found in patient care, but also a lot of the social justice issues. Like I can't provide holistic OB/GYN care without understanding the context of abortion and contraception and birthing care and how maternal morbidity mortality is complicated right now like that. I it's a nice mixture of all those things that I'm really passionate about. abortion provider was a different journey.
I think as an advocate, I knew abortion was important, but personally, I hadn't had an abortion. It was not something that I knew what it was. I just like I knew it was important and I wanted to fight for it, but I didn't know what it was until I went to med school and I was I learned about what abortion was. I learned how it was performed, the medicines that we use. But most important, I got to hear patients stories, people of all walks of life that came to this decision for a lot of different reasons, sometimes social, sometimes medical.
and not just hearing their stories and feeling like I wanted to be able to take care of them, but more so seeing all the stigma that they faced in trying to access care. even within a health care system, nurses that didn't want to take care of that person. I remember one patient that she was there like 17 weeks. She had a severe fetal anomaly where her baby wouldn't survive after delivery. And I remember like none of the nurses wanted to walk into the room that she was waiting in because she was an abortion patient.
So, we couldn't talk to her. And it was just an awful feeling that patients were just ostracized because they were making medical decisions that were best for them and for their families. And so, I knew I had to do something around this. And that made me really passionate of like if no one else is going to take care of them, then I'm going to do it. and so that led me to get subsp specialcialized training in abortion care.
And then now because I now know the political context of abortion, I know that my patients won't get care if it's not legal if they don't have access to it. So I think that's then led me to become an advocate and talk about these stories, talk about the care I provide and why it's so important and why patients need it. Well, thanks for doing it. And you know, it didn't even occur to me that I mean, you want to think that people in the medical profession, people who are in hospitals, who hear these stories, who see these things happening, have like the compassion to care for people. The fact that you're actually seeing people not want to help.
Now, I I remember a friend telling me a terrible, you know, a really sad pregnancy story where she had a still birth and she felt like none of the nurses want to wanted to come in because she was there was so much grief in the room. Like you could hardly be around her like people didn't know what to say. But this is a different story altogether. And that's it's actually really appalling and scary that somebody No, I don't know anybody. I know a lot of people who have had plenty of abortions and I don't know anybody who's like, "Hey, I have an abortion at 3.
" You know, it's never as like it's never like, "What should we do today? " It's because whatever type of attitude somebody thinks that somebody's approaching abortion, I don't ever think is as cavalier or as you know, I don't think it's cavalier or irresponsible. I don't People give thought to this. It's not something First of all, it's it's not the best day. You don't feel great.
I mean, there's a lot that goes into it. I can't imagine somebody not showing compassion, especially in a hospital setting. So, thanks for shining a light on that because I didn't know. so, so based on all of this, which is bananas and you know, we had the overturn Wade just two days ago. The government site reproductive rights gov went dark.
and that's at the time of filming. What do you see as the most pressing challenges in abortion care today, especially considering the political climate? And again, you know, this doesn't mean that everybody on one side of an aisle is anti-abortion, everybody isn't, but as a provider, what are you seeing as the challenges? That's a tough question because I think unfortunately we have a lot of them right now. some of it is just kind of what we've been dealing with in states where abortion is restricted.
Like nothing has changed overnight for them that they continue to try to fight to make sure that our patients have access to care when they can. and it's it's not lost on me that people are dying in those states because of these bans. I think the worrisome thing is now there's an opportunity for that to happen on a nationwide scale. And that's what keeps me up at night. That I think for the past couple of years, we've been talking about safe states or haven states.
These states where abortion is protected like our state in New Jersey. Like New Jersey. Right. Exactly. But it's that's something that I keep saying is like it's safe for now.
people forget that in politics, and again, not a politician, but things I've had to learn, that federal law trumps state law. And so, anything that happens on a federal level now impacts everybody. So, if they overturn Methopton's approval, and so the medication that we use for abortion is no longer legal. That's everywhere. Or if there's a federal ban, that applies to everyone, even if states have laws that protect that care.
And so that's really scary to think about what will the next couple of years look like and what are some of the things we're going to have to that we thought were safe for now but we're only for now. You know, it's it's interesting you say that too because I know that one of the something that our new administration signed within the first days was citizenship by birthight. And already New Jersey is the at the top of the state suing about that. But right now, we happen to have a Democratic governor who's very right pro-choice. So, you know, you really it really isn't as safe as people like to think.
Nothing is as safe as people like to think. Not to not to terrify us because there are options there and there are things we can do which we can talk about that as well. But, okay, good answer. And right, can we talk about how you mentioned people are dying, but how abortion bans intersect with maternal health care and infertility care? What are you seeing as overlooked consequences of these types of bans in terms of maternal healthcare and infertility care?
Yeah. And I think that's actually been one of the most powerful things that's been coming out of these bans is hearing so many stories of people that didn't want an abortion that were impacted by these abortion bans because I think what happens is people thought that abortion bans would only ban quote unquote elective abortions or abortions for social reasons. but in fact if you ban abortion you also ban all the other things around ending a pregnancy even when it's medically necessary. So, a lot of the stories we've seen about people that have died or faced that severe consequences are people that had wanted pregnancies that were undergoing a miscarriage process, for example. either they were pregnant and having extreme bleeding, they broke their water too early and that can cause people to get an infection and that infection can get serious and is life-threatening at times.
And in those circumstances, ending the pregnancy is the way to save that pregnant person's life. But it's unclear with these abortion bans that say ending a pregnancy is illegal regardless of the circumstance what does that mean? as healthcare providers are really struggling to figure out what these laws mean because often they're not written by medical professionals and we aren't lawyers. So we're ending like we end up having to reach out to lawyers that also may have different opinions about abortion and what's legal and what's not. I've had many of friends texting around at 2 in the morning because they're on call in a hospital and are trying to figure out, hey, I have this patient.
This is their circumstance. In a normal world, this is how I would intervene, but now I have to call the lawyer and now I have to figure out if I can give this medicine or if I can do this procedure because I don't know if I'm legally protected. And I think the worst thing about those things is that it's pitting patients against doctors and providers that we're having to decide do we go with our medical judgment? Do we go with the thing that we know is going to be the best thing for that person or do we want to go to jail and also have to think about like our kids and our families and how you know if we lose a doctor in that community that loses the doctor that also does all the other things in that community. and so it's really going against all the things that we went into medicine to do is having to pit us against the people that we're trying to serve.
and you know it you were talking about in cases where somebody maybe is undergoing a miscarriage on their own but there are also cases right where people are maybe diagnosed at you know 20 weeks at an 18 week 20 week ultrasound with a fatal anomaly and perhaps they could opt to carry the baby to term but they know that basically between the time they're diagnosed to the to within five minutes after giving birth that's going to be the entire rest of the lifespan of the fetus or the potential baby that they were planning. So yeah, a lot of times it's compassion alone that lets you make that decision, right? Because technically, sure, I mean people are looking who's it hurting, right? It's just only destroying a family. But otherwise, you know, people aren't clearly dying.
They're just suffering and being asked about their pregnancy all the time. And isn't abortion even the term if there's a miscarriage? Right. It's Yep. Exactly.
Spontaneous abortion. That's the technical term for a miscarriage. Yep. So just saying you're anti-abortion is really kind of a stretch because I mean, aren't we all when it comes to spontaneous abortion? But so anyway, I just was curious about your thoughts about that because a lot of times I don't think people think about that who aren't in the medical field, right?
And I think people are surprised to meet me as an abortion provider and learn that a lot of my job is what I call sad abortion. It's abortion in circumstances where people didn't want to be there. They never thought they would be seeking an abortion, but because of something that happened in their pregnancy, something maybe that happened in their health and that it's dangerous for them to be pregnant. they need that service. and like you said, it'll be abortion on the paper or the bill, but it's the same it's the same procedure.
It's the same medicines that we use regardless of the indication, but people come for so many different reasons. And many people don't know that these laws don't specify, oh, it's okay in these circumstances. There are some things that are exceptions. often they are written in ways that are extremely limited. meaning that you actively have to be dying for us to be able to evacuate your uterus.
And like really dying like it's got to be far enough along where there's no question that you're dying. Yeah. But the problem with that is that well one maybe I shouldn't wait till you're actively dying to do this. Maybe I should be able to diagnose a problem and fix it right then and there. Not wait days or weeks or, you know, wait till you're on the brink of death before I intervene.
And that's what and that's what these laws are telling us to do. So, first of all, we're having to like fight our urge to stop the process, whatever the illness is, we have to wait. And these laws don't say when, like, do you have to be like, let's say you're hemorrhaging. do you have to lost one liter of blood, 2 liters of blood, 8 lers of blood? How many blood transfusions do you need before we have to intervene?
When you're septic, you're infected. Does your fever have to be 105, 108? Do you have to like has your heart had to stop for us to intervene? There's no rules about this because again medical people are not writing these laws. And so for us it's like well we just want to intervene when we know the problem exists.
How can we wait and when how long do we wait? It's incredibly confusing. And so even though there's exceptions, they don't actually mean anything because on top of all that, all of us are afraid that if we intervene at the wrong time, then we go to jail. Like that's always the consequence of like we wait and wait and wait, but there's always a chance we do it too soon and then we go to jail. Like how is this a real way to provide healthare and the person dies?
It's actually almost reminds me of like something as preposterous as like you know my daughter was into the Twilight movies. Did you ever see the Twilight? You know, do you know the concept of it? Like somebody a vampire, but basically like they have to wait till she's at death's door to make the bite to like have her become which is obviously fiction and that's why it's an exciting movie because it's fiction and it's not real. I mean, the fact that you're being put in these positions in hospitals and healthc care settings where your natural inclination and the job you've been trained to do, which is take care and take care of your patients and basically prevent them from getting this way because I'm sure the recovery process is significantly worse if you're on death's door versus, you know, a week or two before you got there or a day, you know.
Yeah. Okay, deep breath. Deep breath. so I sorry. So shifting a little bit away from abortion but not entirely.
Your research highlights contraceptive coercion. Can we talk about this? And you can we tell our listeners exactly what this is, how this shows up and how we can combat this as well. Sure. Combating a lot of combat.
Yeah, we're going to fix it all. This is great. right here today. Yeah. And I think it's it's kind of talking about the same things.
So, as a physician, my goal ultimately is to make sure that my patients have all the information to make the best decisions for themselves, whether that's in a pregnancy for birth control for when they get a papsmear, all of that stuff. I'm not someone that says like, "All right, you're here. This is what we're going to do. " my job I really consider my job a lot more as a counselor that I talk through here are the risks and benefits. Here's what happens if you didn't do this or if you did do this.
And ultimately you as the patient get to decide what you want, what's best for you, for your family, for your needs. and I think birth control is no different. But it's become more and more of a conversation, especially now adding on this layer of abortion stigma and whether or not you have access to an abortion, that contraception is critical, but also not mandatory. And it's something that it's become a deep conversation of how much do patients get to choose what birth control method they want to use. how much we push that yes, you should be on something, you should be on this thing that I think is best for you.
so the idea of contraceptive coercion is that someone other than you as the person using birth control are someone else is making the decision about what you use or how you use it and it can go in either direction. we see this for example in relationships with intimate partner violence where the partner will throw away their birth control pills to try to get them pregnant or we've had stories of patients who there's partners pulled out their IUD to try to get them to be pregnant. Yeah, it's a whole thing. yeah. And so, or vice versa.
I've only heard about how painful an IUD insertion can be. So, that just the thought of that is like Yes. It's awful. That's very awful, right? So, like we've seen this kind of in these relationships or maybe a parent for example, like a parent deciding like, oh, their kid's going to be on birth control now that they turn like 16 even if the kid didn't want it.
So, that's I think the normal conversation we've had around coercion and people being pressured to use birth control or to not. We're now talking about it more in the medical space of providers pushing people to certain things. So, for example, imagine if you're in a state that has an abortion ban. Your patients, you know, are not going to have access to abortion unless they have to travel or do all these things. There's a lot of mindset of I really need to talk to you about birth control because if you get pregnant, you can't have an abortion.
So, the consequences are higher. Let's give IUDs to everybody. Let's give implants to everybody. So, there's like that step of like we care about our patients. we care about our community and we want to make sure that they, you know, can choose to become pregnant or not.
Going back to reproductive justice, but going a little bit beyond that and being more paternalistic and saying, "Hey, actually, let's put an IUD in today. " There's like a line that people are crossing. And so that's why I've been talking and doing research about contraceptive coercion to understand, do patients understand this? Do patients feel this? Answer is yes.
and do providers know this? and providers also the answer is yes that they know that they're doing this in some circumstances. Some it's like because we care others you can go back to racism and sexism and those kind of things. but it's a really complicated issue that I think we need to talk more about how do we center patients and help them make decisions about what they need versus us saying prescribing and making mandating essentially what they need. Do you know when you first were talking about when I when you when I was going over this before we talked and I was like coercion I very much 100% thought it was spousal partner coercion it didn't even occur to me that it would possibly be from again I must have these really high expectations of my doctors I love my doctors I have great doctors I mean even as recently as going to my regular OBGYn and I was like you know I'm having night sweats I want I want hormones.
She was like, "Okay, let's talk about this. Do you want to do this or do you want to do this? " Like, you know, she's like, "I know you. This is what I think, but maybe you're practicing something different that I don't know about. " So, it's interesting to me that you're seeing this and I am I'm curious and again, sorry I'm just blanket judgment, but I'm assuming and I could be wrong, but you did mention paternalistic.
So are these kind of like I want to say gross overstepping but I understand that people are coming at this in a protective way but that like you said there's a limit and people have choice and so you can't decide you know I think our new president one time said something in the election of like we're going to protect women whether they like it or not and it's like well that yes so is it that or is it coming from women just out of curiosity just and this isn't like a study or maybe it is but just your interpretation of it. Yeah, I mean it's coming from all different kinds of places and I'll tell you that I faced this myself personally as a patient. I was a resident nob I came for birth control I was like I want an IUD came to my doctor I was like oh yeah I want an IUD and I thought they'd be on board. I'm like actually no I don't think that's the best thing for you. Like why don't you try this thing instead?
I'm like, I'm an OB/GYN. I kind of know the pros and cons of birth control. Like, I've gone through the methods and even I face barriers to getting the thing that I wanted. was it from a woman? Yeah.
Yep. Really? And I think Yeah. And it's coming from a lot of different places. No.
and the study that I've done to look through this patients have faced it from a lot of different places, a lot of different people. some people feel like it's kind of a protective thing like I've talked about like in circum circumstances like abortion specifically that people feel like oh they don't want them to have to come back and do all this stuff again for another abortion. Here why don't you do something that's highly effective in preventing pregnancy like an implant or an IUD. The reason why I actually did my study in fellowship is because as a fellow I was working in a contraception clinic and I had a lot of people coming for IUD removals and implants removals and I was like oh yeah you know why didn't it work for you? Like is there something we could talk about differently?
And they're like yeah I didn't really want it but like I felt like I needed to get it. and that's kind of like the spark that kind of led me down the pathway. I think it's also in part because that's how physicians are starting to be trained in some of this birth control stuff. The way I describe it is let's say you have high blood pressure high blood pressure. Usually when you go to your doctor for high blood pressure, they're like, "All right, here take this medicine.
Try it. If you hate it, come back. " And usually it's because we give you the most effective medicine. You have side effects that suck. And then you decide, "No, I don't want to do this anymore.
" People are starting to talk about birth control in the same way. If we know that there's some methods that work better than others, why would we recommend a method that doesn't work as well? We know that pills don't work as well as an implant. Implant is the most effective form of birth control. IED is number two.
Tying your tubes is number three. If we know that they're the most effective. Yep. People don't know that, too. So, I also throw that out there.
Okay. Yeah. Thank you. That's good. Okay.
Sorry, my voice is going up like 10 octaves. I again, this is important information for people to know. So let's say implant most effective form of birth control we have. Why wouldn't we start with that and say here person that comes for birth control try the implant if you hate it then we'll try the IED and if you hate it then we'll talk about maybe pills maybe the shot things that don't work as well. This framework of an unintended pregnancy is a disease that we're trying to prevent or to control.
So we're giving the most effective thing. But that's not how birth control works. there's a lot of different reasons why people choose birth control. They choose it because of the cost. They choose it about like do I have to take something every day or every week or every year.
they may have time to come to the healthcare center to take out their implant or IUD. Like there's a whole bunch of reasons why people choose the birth control method that they choose. And generally if it fails 8% of the time versus 1% of the time for most people that's fine. So we're kind of putting our own stuff on patients to say like we think this is best so you have to comply with this. But is it like an IUD or an implant?
Now I don't have either so correct me if I'm wrong but are they not like a little bit more invasive than taking a birth control pill? Right. Absolutely. So it's I mean you know you I'm thinking about my cholesterol. So I have high cholesterol.
I went to a cardiologist. He gave me aderv atastin. Okay. It's a it's a statin. Okay?
Because this is known to work. What he didn't say is, you know, hey, let me plunge a needle into your heart. Like what he didn't do is something invasive. So just the fact that's the first option, even if it's more effective, seems like a really big leap from I just want to protect myself from pregnancy. Not to mention that I feel like, you know, you're protecting yourself from pregnancy, but then there's also the whole series of sexually transmitted diseases that you can get, so infections.
So, there's that as well, but forget that. Just go back to it seems like it just seems like a lot. So, it's shocking to me, but you're you're seeing it and this is actually happening. Okay. Okay.
It's good. And so, now we're trying to shift the conversation now to like what do you want out of birth control? What are your goals? What are your wishes? Like, do you want to do something every day?
How do you want your periods to look? Do you want periods? Do you not want periods? " Are you also Oh, go ahead. Sorry.
But also, I think not only do we need to start having that more patient centered conversation in birth control, we also need to talk about that like the statin that you got, there's like 15 different statins. How did he decide on that one? you know, like it's one some of them have different side effects than others, but I imagine you didn't really have a conversation about like, all right, there's five medicines I can put you on. Here's the different side effects. This is how often you have to take it.
Which one works best for you? You're doing that with everything. You're right. You're absolutely right. And I and I'm sure that it's got to be as a as a physician, first of all, there are less physicians.
And you know, I just read a headline that, you know, where are all the physicians? the baby boo at some point there was a cap I guess on medical schools and how many students they could allow because there was just so many doctors which seems outrageous now and then nobody accounted for the baby boomers and now we've got this like aging population with less doctors I mean I'm sure I'm not the only one who's called a doctor and said I don't feel good and they're like we can see you in three days and you're like but by then like right like what so which is crazy because I'm I'm 50 so you know I've around for the period of time where you could call the doctor and go that day and and I've seen how it's shifted. And I'm not saying it's like that everywhere, but I think it's less uncommon for your doctor to say, you know, you have to wait. it's just I think with the time that they have, these doctors are so needed, maybe they don't have the time to educate every single p patient on every single thing. So I get it.
" Yeah. I mean, I don't know what the answer is, but I would I would gather that it's not let's insert you with an IUD. And I'm wondering and you know, you talked about spousal, but you also talked about a parental portion. Are you seeing an influx of And I've saw this myself personally. I have a 16-year-old daughter.
She just turned 16. And so as soon as this started coming down the pike, I mean you see on social media, you see on networks of mothers, not that it affects me or my daughter directly, but she has friends. I mean people you live in a community. I went and bought a bunch of plan B's. I have that at our house and no, they're not going to last forever.
I think it's a six-month shelf life, but I'll buy them again in six months. I'll buy them as long as I have access to them because sometimes people might not. so are you seeing coercion from that regard? Because I know there are a lot of moms and I think my OBGYn mentioned this as well. She's seeing a lot of moms panicking about, you know, the next couple years for their own daughters.
" whether you know whether you like it or not. I mean, I think it's it's definitely happening and I think it's something that I try to temper when I'm with patients and when they bring their parents with them. and try to have a conversation about what are the goals like what are you worried about? and but at the center of it, at least in New Jersey, the patient in front of me is my patient. the mom isn't the patient, the parent isn't my patient.
and so I usually try to have a group conversation and then ask the parent to leave and then talk to the teenager and be like, "So, what's really happening? Like, are you act do you actually want to be here? " Right? Right. Just to make sure because again, like it's my duties to that person.
" but I think it's also something I really strongly recommend that teenagers when they come, bring your parent so we can talk about it as a group so you don't have to hide your birth control pills from your parent. or kind of have this conflict when we could all try to come together to a consensus of what's best. But I understand the panic like right now it's a scary world. something else that kind of that triggered for me as well is again there's a whole bunch of new bands and restrictions that are coming into place. One that's been really particularly harmful, I think, is these trafficking bans.
I don't know if you've heard of these trafficking bans. so, a couple states have passed bans saying that if a minor is taken to another state to have an abortion, that is considered human trafficking. And that person can then like the person that took them aunt, grandmother, you know, whoever, has fines, goes to jail, like does all the things to like that's that's human trafficking. Like we actually have a human trafficking problem. Yes.
100%. That's what they're going to say is human trafficking. Yep. So again, yes, there's already there's already been rules for years about minors accessing abortion, accessing birth control that may get worse, but like these are the kind of things that people are thinking about to protect minors, which is again bananas. Have you ever heard of I'm sure you've heard of it, but I actually just read a fiction a fictionalized account of it, but it was ba you know I read obviously all the author's notes about how it was based on a true story about the Jane network and how Yeah.
And I mean I'm definitely one to jump my imagination can definitely get ahead of me and I read it to my husband. I'm like we're like five steps from this. I was like, but it's I'm laughing because it seems preposterous, but so do so many of the things that have happened. yeah, but just for any listeners, the Jane network, I believe, was in Canada and parts of the Illinois area where there were women who were not OBGYn. Some were, it was originally OBGYN, but they were trained how to do abortions in a safe way.
and they provided these abortions when abortions were illegal. Mhm. And I believe one of the women is still living, which just goes to show how far the pendulum has swung and swung the other way in like what's really not a long time at all. since we're talking about abortion again, I just it comes up when I'm in rooms apparently. I'm so sorry.
I was like I I had a whole thing on patient care. I'm like I have a question. So, I just read this yesterday and it's actually in an article that you're interviewed in, but New Jersey specifically where you know you mentioned and we all know New Jersey right now is one of the safe states and obviously it's state byst state right now. So, there's no federal ban. So, if the no federal ban thing is really real and we get a Democratic governor, then we have a chance of staying a safe state.
Safe. I'm using air quotes. So however in as of November we had 59 anti-abortion facilities which is nearly twice the number of medical clinics that perform abortion. com. Can you explain to our audience why these facilities are a problem and what may or may not happen when people go there because sometimes they go there thinking they're going to get an abortion.
Yeah. these so these places which many people talk about as crisis pregnancy centers are like the bane of my existence re recently I'm glad I asked so a crisis pregnancy center is a place that is not a licensed medical facility it's a place that's often run by people with a religious background or people that are anti-choice and their goal is to provide resources to patients with a very clear anti-abortion agenda. so it's very interesting. It's a lot of masquerading as a healthcare clinic. So there's people that wear white coats that aren't physicians.
There's people that do tests that aren't lab techs, that do ultrasounds that are not ultra synenographers. and it's very shady and very like just complicated in that they aren't regulated like a healthcare facility. So, they don't have to do any of the things that like a healthcare facility I work at does. but often what happens is they trick patients into thinking that they got medical care when they didn't. " They never say that they can offer abortions because they don't.
you get there, they will often do a pregnancy test, meaning they'll give you a pregnancy test to run yourself because they can't run the test themselves because they're lab because they're not a medical they're not a lab. they will do an ultrasound. Again, some have ultrasographers, some don't. Some have doctors, some don't. and so the accuracy of that ultrasound is less than stellar.
I've looked at many of these ultrasounds because I have patients that go to these clinics and then come to me. and so I like look at the information that they've gotten like I don't know what they're looking at. but often ultrasounds say things like here's your baby. And they have like a picture and they like point to like a blob that I don't know what that is. so and then they get prenal vitamins and say all right go home if you want.
Come back and get diapers. like we have some resources for you. and what exactly are the resources? Like if they're offering them options, what are the options exactly? There are no options.
It's just go Oh, yeah. It's the goal is to not talk about abortion to prevent them from going to a place that is licensed to provide that care. It's also like some places have different levels of resources and I will say some places are state funded or federally funded and so they have lots of resources. So things they offer are things like pregnancy classes. They'll give diapers, maybe car seats depending on the resources that they have.
they may talk about different parenting options. Like it's stuff that is very centered around parenting, which may not be the reason why that person came for those things. But an important piece of that is that all of it's free. And so if you think about it from a perspective of like who are the people that need this care that go to these centers, often it's marginalized folks, people that are low income, people that don't have health literacy and like they saw they, you know, you go to my clinic where you have to pay like a couple bucks to get a pregnancy test run by a lab or you can go to this place and get a free pregnancy test and a free ultrasound. It's incredibly predatory.
which is so problematic. and then when they can't get an abortion in these centers, then those patients come to a center like mine, where we then have to like start over. And not only start over, like actually do a pregnancy test, do an ultrasound that's like legitimate. but also we then have to like go back and explain all the stuff that they've already heard from somewhere else about how abortion causes breast cancer or abortion. like they give all this false information and I have to go backwards now and be like actually here's what the evidence says.
This is what the science says. This is what medication abortion is. There's nothing there's nothing like medication abortion reversal. So much like backtracking I have to do to give people the information they actually wanted in the first place. And isn't it true that sometimes these nefarious practices act and I'm calling them nefarious practices because clearly whatever their intention is it is completely been warped and this is no way to treat anybody by deceptive tactics and things that can Isn't it true that they will sometimes tell women that they're further along in their pregnancies so that they basically miss any type of cut off that there might be because they think they're further and they're waiting.
and they're waiting, right? So that so that's the problem again when it's not a licensed facility, they don't have any standards that they have to do the ultrasound correctly in a proper way that we can actually interpret and use medically. so not only will they deceptively tell people that they are farther along than a state limit, for example, or that you know I've had patients that came like I that patients came like oh I'm six weeks pregnant by this ultrasound and actually do an ultround. They're like actually know you're 18 weeks pregnant. very different than what you thought.
so either it's given false information or they just don't do it properly and get false information. I've heard horror stories of people misdiagnosed with attopic pregnancies that are really dangerous that they got an ultrasound and they said, "Oh, everything's fine. " terrible things because again, they're not a licensed facility that can actually do these things in a medically appropriate way. But patients don't know that. And you're telling me that, sorry, you're telling me that a lot of these places are state and federally funded.
So basically, and that they're so we've got a federal abortion, you know, federally we have is it an abortion ban? We don't allow abortions, but it's a state-by-st state decision. But federally, we're not supported in abortions at all. Are states even in any way supporting abortions? Because how it just seems really odd to me that in a country that supposedly values church versus state, which I guess we don't, we're leaning towards these non-medical facilities that, as you said, often come from a religious type of background, right?
Because technically a lot of the people who are opposed, vehemently opposed because some, you know, to each his own, right? you can get an abortion or you cannot get an abortion. I think that's the whole point. It's up to everybody and their own individual circumstance. But, you know, if my neighbor doesn't like abortion, oh well, she doesn't have to and I can and that can be we can coexist and that can be okay.
But when you're agreemently opposed to the rights of other women achieving their healthcare in any way to the point that you're willing to deceive them, it seems really shocking that this is something that we fund on a state or federal level. It to me it seems like something that should be kind of like a hidden in the shadows like we're operating secret and as soon as they find out they're going to shut us down. But no, they're actually receiving funding. Yeah, that's that's I think one of the hurtful things about it because I know like you know healthcare clinics and facilities are suffering because they don't have enough state funding or federal funding. and like you said like I think I would have no problem if there was a church that was offering free pregnancy tests, free diapers in the basement of their church.
Like if that's a thing that they want to do, fine. That's great, right? But the fact that they are wearing the same white coat that I'm wearing that I earned is really hurtful. and that it's deceptive and that you're, you know, you're basically calling yourself that to get women to make a choice that is not necessarily in their best interest. Not that every woman who wants to talk about getting an abortion is going to choose to do that.
Pick up their minds because they do. I but I but I rather they do that with proper medical information and not with misinformation or misleading information. Like I've had many patients that have come to seek me at seek my care in an abortion clinic. We talk about options and you're like actually no. I don't want to do this today.
I'm like fine, great. Here's our number. Please call us if you need us. let me set you up with a prenatal appointment with someone else. Like that's fine.
It's not my agenda to h make sure every patient that walks in my door has an abortion. My job is to make sure people are informed about the medicine so that they know what's going on in their body and they can decide. But when people are take Yeah. take No. when people are taking it into their own hands and making decisions for patients regardless of what it is.
I think that's where we need to draw the line. I almost just like burst out laughing when you said it's not my agenda to have every patient that comes to see me get an abortion like because that seems very crystal clear to me and it and the fact that possibly people think that of you is I want to say laughable if it's not so scary. but it's a scary time. So I so I have two questions. I'm going to put them both to you at the same time because, okay, based on all of this information and then I'm actually asking you the second one also just so I don't forget.
Two really final questions based on this and you are a wealth of information. I really feel like I could stay on the phone with you all day except I feel like the whole time my mouth's going to be hanging open. So, so there's two things. How can our listeners and their daughters or their mothers advocate for themselves with their own doctors? And also a lot of the women, you know, the whole premise of this podcast and the reason that I wanted to do it is to identify women who advocate or support other women in one way or the other, whether it's through abortion care or, you know, bringing them fruit baskets when they're sick.
You know, I mean, there's a lot of ways to support women. but what I've learned is a lot of the people that I've spoken to and a lot of listeners, a lot of people don't feel okay just listening. then they feel like they need to do something and you know for office isn't always the answer or becoming an OBGYn isn't always you know as absolutely as I want to help you there's no way I'm going to medical school right now it's that's fair it's a lot thank you thank you and nobody wants me there so what that in that case if they want to do something in the arena of reproductive justice where can they learn more about your work and where can they support advocacy efforts so it's like a three sure Sorry. Oh gosh. Okay.
Come back. No, it's fine. So, the first one is how can they advocate for themselves? Yeah. So, I think there's a couple things that people can do to advocate for themselves in a healthcare setting.
one is starting when you make the appointment. So, figuring out when you talk to someone to make an appointment, let's say you're seeing a gynecologist, ask like how long is my appointment for? will I get who will I see? Like, will I see what type of provider? just so you know because sometimes you can see a doctor, a nurse practitioner, a PA, all qualified people to see you, but you may want to know what kind of provider you're seeing.
and I would say also that like as much as I love being a doctor, nurse practitioners, other allied health professionals are great at centering patients because they were nurses and then they became like practitioners. So, they have different training and different styles that you may prefer over others. So, something to think about. and like in general asking questions on that first, like just making the appointment helps you get a sense of are they just trying to get your appointment and hang up the phone or are they actually listening? Do they care about you?
Same thing when you get to the office. Like ask questions. And if you feel like you can't ask questions, then that's not a good place for you. especially if you like, you know, you are going to see a doctor for about 10 minutes. That's how long your appointment is.
they're going to be in and out and they're going to like you're not going to have the time to have a decent conversation with someone. So, if you're looking for that, try to ask questions ahead of time. Look at reviews, things like that to see if you can get that sense. do they have an online portal where you can send messages to your providers to ask them questions because maybe you didn't think about it in that time, but maybe you will have a question you want to follow up with them. Can you email them?
Can you send them information afterward? So, so find this all out. kind of do your research before you get to the doctor. Yep. If you can and also again like ask a whole bunch of questions and if you feel like your questions aren't being answered or you're not being heard, then that should be a red flag that something is going on and that's maybe not the best place for you to get care.
You know, sometimes I feel and adding on to this, sorry. Sometimes I hear people and I myself am can be guilty of this. " Like, you know, I already have this like sort of relationship with my doctor. Should you feel bad about getting a second opinion or asking more than one doctor? No, I don't think so.
I think all doctors are humans and so they're going to make mistakes. They're going to do their best and they will try their best in the circumstance that they're in. But if you need more information, if you want to, especially if you're making a big decision like a surgery, you may want a second opinion just baseline just to get a sense of what are different options. Maybe that one person doing a surgery only does surgeries in a certain way and you may want to do things differently or you may want to know what else is out there. So getting different opinions is the best way for you to get information so that you can make a good decision for yourself.
and I'm never offended like I've been the person that does the second opinion and I've been the first doctor that they then go to the second opinion and don't come back and that's fine because that means that person made the best decision for them and maybe I'm not that and that's okay. Okay. And then and then regarding the urge to do something to support not just well you but also reproductive justice in the world like I do know that at Planned Parenthood sometimes there are you can have like basically support people. There are support people that can walk you in. What are some do we have that in New Jersey?
And what are some other things that people can do to support reproductive justice so that people have access or feel safe getting access? Yeah, there's so many things. so you mentioned support people. So, lots of different places have either people that will walk you into a clinic or out of a clinic if you if you need that. and you can volunteer if that's something that you're passionate about.
If you want to be it's called a clinic escort. so if you Google clinic escorts in your area or if you contact your local clinic and say, "Hey, I want to help support you. " where you literally just like have headphones on and you walk someone in and walk someone out. Great option. there's also doulas.
doulas, we hear a lot of them about them in birth that they're people that are support people that go with you during a delivery. They're also things called abortion doulas that also can help you through that process. So that's something that if you're interested, you can get training to do that. Yeah. So that's another option.
maybe easier things or less labor intensive things you can do. donate to a local abortion fund. New Jersey has New Jersey Abortion Access Fund, which is a great organization. And full disclosure, I'm on their board. What's the fund?
I'm sorry. New Jersey Abortion Access Fund or NGAF. and so you can donate to patients so that they can get care. so abortion funds are great. I think also of note, people donate a lot to Planned Parenthood, which is a great organization, and also doesn't provide the majority of abortion care in our country.
most abortions happen in indie clinics or independent clinics and so you could donate to abortion clinic network which helps people get funding to clinics that are providing care particularly later care. Most later care happens in indie clinics. other things I was thinking about protecting your digital safety. That's something that I don't think we talk about enough. So things like disabling location sharing.
There's a whole bunch of like apps that will track your pregnancy or track pregnancy but also track your periods. and so those things could be potentially worrisome if you are traveling get an abortion and they see that you were pregnant and also traveled somewhere. You're creating data points for people to use. So that may not be helpful. Using things like Signal, which is a or other secure apps for communication.
there's mutual funds that you could help raise money for people in your community. we talked about like getting birth control just in case. You can also do that for abortion. So if you want methopristone, you can get what's called advanced provision of medications. so you can have me mythopristone and misoprosttol at home in case you need it.
like a plan B type of kind of like a plan B, but for abortion specifically like you know you're pregnant, you would like a medication abortion, you can have that kind of ready. I think something we didn't talk about is POST. Palmtock is a federal law that it's like a really ancient law. It's 150 years old. It's an obscenity law that prevents information from about abortion, contraception.
It prevents things in the mail. and the reason why I mention it is because it can be a game over if that's something that is really enforced by our federal government. We won't be able to get medications mailed. we won't be able to get equipment to provide abortion because they make them in different, you know, states that have to travel to us. so the other thing is talking to your local legislators about Commtock and telling them to overturn it because it's still a law on the books even though it's 150 years old.
So talking to your legislators, old school advocacy. The alternative to that would be people literally driving through states to try to get supplies independently and not through the federal mail. Yeah. I want to add on here because I've spoken I at one of the podcast episodes I did have I went to a fem conference in June which was awesome. There's so many women doing great work for women and it's it's amazing.
but one of the women that I met there was named Anna Hall and she created the first private by default period tracker. So it's so and she did it on the blockchain and ask me what that means. I could not possibly tell you. However, it's so private you can't even So, say you get a new phone, it doesn't come with you like which is can be problematic. And I believe that they've actually just done something to combat that because you want to have your own data.
but I've been telling moms of teenage girls about that or basically anybody who can who is, you know, at the age where they could become pregnant about that app because a lot of them, you know, the thing about this app called Embody is even if they're subpoenenaed, they can't get the information to turn in. So, right, they're they're off the hook. They've basically created this. But other apps don't have that luxury. So, if you say you use well, I'm not going to name any of them, but any other period tracker, if they get subpoenaed for the information, they're going to turn it over.
I mean, whether say they are or they're not, they're not going to risk getting shut down and lose the M. So, right, I'm with you. And I was and that was another thing that I was really surprised by. " But it was interesting to see exactly why and what happens behind the scenes at those companies. So but thank you for all of these tips.
I'm gonna so it's com stuck. Okay. Was there anything else? I think the last thing is just we talked about it. We're we're at the anniversary of row.
It would have been 52 years today. I think everyone's everyone misses row. Everyone's like we should reinstate row so that way people have legal protection federally for abortion. But I think one thing that we need to keep talking about is that yeah, we should probably do that, but row was never great to begin with. there's a big phrase out there that like row was the floor, not the ceiling.
that even with row, even with abortion being legal, there are a whole bunch of people in different places that couldn't access abortion because of costs, because of travel, because of lack of providers. So, yes, we need to do all this work to get state and federal protection for abortion, but there's so much other stuff thinking about reproductive justice. There's so many other things that impact people's ability to access this care, to get it safely that we need a we have a lot of work to do. so legal is one thing, but also make sure that health insurancees cover it. make sure that there's travel costs that are paid for just like other like health care where you can get a a shuttle to get to your appointment.
We don't have that for abortion. Things like that. Like what are some things that we can do to make abortion more accessible for folks even if it's legal? Oh my gosh, you give us so many things to think about. I really appreciate it because it really is it just really runs the gamut and actually it should come as no surprise because we're really dealing with a country where in Congress I believe the very first Congresswoman is giving birth while in Congress.
Like we're not a country that is built upon supporting women. So we're not thinking of all the ways we can support women. So, and I was going to say does access say there was still row did access to abortion did it become a little less of a financial hindrance when it because I understand most abortion doctors it's not the old way of like a DNA or a DNC now most of the time you can use a medication right is that correct did that lower the costs for patients or not necessarily so in my practice, I tried to make sure that medication and procedure were equal cost because I didn't want people to choose medicine or procedure based on how much it costs for them. But on top of that, most insuranceances don't cover abortion. and Medicaid, which is, you know, many people seeking abortion are doing so because they can't afford to have a kid in that moment.
So people that are on Medicaid, most states, Medicaid doesn't cover it. and our state, even though it covers it, it covers it very low. So many people that provide abortion don't even take Medicaid because they can't reimburse the costs of their ultrasound machine and their pregnancy test. Like, they can't recoup the cost of providing the care. So, they just don't use it or don't take it as an insurance.
So, again, so many layers of things that prevent people from the care they going so far back. I'm like, I can't thank you enough. And I feel like I know you don't want to be in politics and you have your job to do, but you really have so many great suggestions. Is there a place we can I'm going to I was just going to say I'm going to put all your links online so people can find you afterwards. Okay.
But if you have any other suggestions for things people can do and you after this call if you want to send them to me, I'll definitely include them in the show. Great. Thank you so much. I don't even want to let you go, but I will. Thank Thanks so much for having me.
Thanks for this conversation. Thank you so much for being willing to have it and for doing the work that you do for all of us. Thanks for listening to Roar. If this conversation challenged you, inspired you, or reminded you of what's worth fighting for, share it. Text it to a friend, post it to your stories, leave a review.
It all helps us keep these conversations going. and make sure you're following the show wherever you get your podcasts. Next week, I'm talking with Jenny Lynn Walding, a mom who hit the same wall so many of us do during breastfeeding. " She did more than talk. She built something that could change the game.
And that's what we'll be talking about next week. You won't want to miss it.
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