We must be ferocious in demanding access to reproductive health care

Updated: Oct 25

By Julie Blumenfeld and Arielle Cheifetz

Originally published to NJ.com on June 25, 2021

Access to contraception, quality care in pregnancy, and abortion are essential health care services, and all people should be free to make decisions on their own terms about whether, when, and how they want to have a family. But here in New Jersey, that freedom tends to depend upon affordability.

It’s time for New Jersey to take action to protect the reproductive autonomy of all its residents. The Reproductive Freedom Act is long overdue legislation that would break down systemic barriers that reinforce unequal access to patient-centered health care. This vital bill would accomplish many important reforms, including:

  • Reducing the factors that make it more stressful, expensive, and time-consuming to obtain contraception by ensuring that all people have access to at least 12 months of contraception care at a time with no out-of-pocket costs.

  • Abolish medically unnecessary restrictions and requirements for providing abortion services by expanding those who are able to perform the procedure beyond just physicians to all healthcare providers trained to provide abortion services. Remove financial barriers to end a pregnancy by ensuring that insurance covers the costs in full.

  • Guarantee full coverage of reproductive care at no cost to all people — including those who identify as transgender and non-binary — and change the language of existing laws to reflect this coverage.

  • Affirm that all pregnant people have the right to quality prenatal, labor and postpartum care.

New Jersey prides itself in having excellent health care, but the fact of the matter is that the state fails to ensure equal access to quality care for its most vulnerable residents. Each year, pregnant people across the state receive prenatal care through a special funding stream called the New Jersey Supplemental Prenatal Program. This program provides funding for essential care during pregnancy for people who do not qualify for Medicaid, including undocumented immigrants and migrants — people who are often the most susceptible to high-risk pregnancies.

However, the funding for this program typically runs out within just a few months, leaving people to scramble to find other ways to pay for their care. This leads to a loss in continuity of care and huge gaps in coverage for the most vulnerable populations of moms and babies in the state.

Midwives in New Jersey know firsthand how these gaps in coverage harm our residents. They’ve seen pregnant people go without basic necessary lab tests because the nearest hospital that provides charity care is so far away.

They’ve seen pregnant people require urgent blood transfusions on the day of their scheduled cesarean sections because they couldn’t afford the cost of a hematology consultation visit during their pregnancy. And a pregnant person resort to community fundraising for a life-saving prescription drug not covered under the state’s prenatal program’s current rules and a patient having a fifth child with an abusive partner because they couldn’t afford an abortion.

Midwives have had to talk with pregnant people about whether they should spend their limited money on antibiotics for a mild urinary tract infection or wait to see if it progresses into a kidney infection that requires hospitalization so emergency insurance will cover it. Health care is a human right and the ability to decide when, whether and how to start a family is the basis of having healthy families.

This year, the governor has proposed a major increase in funding to the New Jersey Supplemental Prenatal Program for both continuous care throughout pregnancy and an expansion of services to include contraceptives. This is a great start, and we need to keep this momentum going. We also need policy to keep this coverage in place beyond this year.

In January 2021, First Lady Tammy Murphy launched the Nurture New Jersey Strategic Plan for improving the health of women and families across the state. This plan calls out the systemic racism that has contributed to poor infant and maternal health outcomes in New Jersey and includes a call to action of “systemically restructuring the system that holds racism in place.”

The Reproductive Freedom Act is a key component to answering this call. With this bill, the people of New Jersey are guaranteed the right to a full range of services involved in planning a family: access to contraception without fear of denial of coverage, exorbitant co-pays, or coercion into or out of a specific method; access to quality, compassionate, and respectful care in pregnancy; and access to abortion without unnecessary barriers.

The key to this bill is its ferocity in razing barriers to accessing care across communities — barriers that often disproportionately impact people of color, those who identify as LGBTQIA, low-income families and immigrants. This bill would ensure that all people have equal access to the tools they need to plan for their reproductive futures. We need you to speak out now in support of the Reproductive Freedom Act so that all people and all families in New Jersey can obtain the health care they need.

Julie Blumenfeld, DNP, CNM, IBCLC, FACNM, is president of the New Jersey Affiliate of the American College of Nurse Midwives.

Arielle Cheifetz, MSN, CNM, WHNP-BC, is on the legislative committee of the New Jersey Affiliate of the American College of Nurse Midwives.

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