LAUSR

When, as a woman of reproductive age, I knew I did not want to become pregnant, I was fitted for a diaphragm. My insurance covered this choice. Straightforward. When I got pregnant using the diaphragm while struggling to finish school, I was able to have an abortion. Not so straightforward, but manageable. When I wanted to marry the person I loved, no problem. When my partner and I decided we were ready to have kids, I had my IUD removed and started taking prenatal vitamins. Also straightforward. Women in the future will probably have a different experience. Guarantees are off for access to long-acting reversible contraception (LARC), emergency contraception (EC), birth control methods covered by insurance plans, abortion, comprehensive sex education, and legalization of same sex marriage. The future of a woman’s right to choose, access to a broad range of contraceptives, and a broad notion of reproductive rights and sexual health in our country seems very uncertain. With a new administration, the Supreme Court appears likely to become a battleground for these issues. The Affordable Care Act is at risk. The incorrect belief that IUDs and EC are abortifacients is common. “Bathroom” bills, legislating which bathroom people must use regardless of their gender identity, are law or under consideration in 11 states. Efforts to promote abstinence-only education and virginity vows, despite their failure to prevent pregnancy, are ongoing. There is strong support for the essentially contradictory positions of opposition to abortion and opposition to access and availability of highly effective contraception. The dismally high rates of unintended pregnancy in the United States and the limits on options for pregnancy prevention disproportionately affect adolescents and lowincome women. While it is not unreasonable to fear a rolling back the last 50 years of progress, the important question is what is to be done? Certainly we will experience discouragement, but that must not keep us from action. As public health workers, as nurses, as caring and concerned human beings, we must continue to help women keep control of their bodies and ensure that sexuality is not controlled by politics. This is no time to sit in silence or walk away from difficult conversations. If there are threats to ban abortion, and you are one of the millions of women in this country who has had an abortion, you will need to speak up. If your agency threatens to defund critical access reproductive or sexual health services, actively advocate for their continuation, using scientific evidence. If your curriculum committee has not made reproductive and sexual health a part of every health professions’ curriculum—not a 1-hr lecture, but integrated throughout all courses, reflecting its centrality to the reality of people’s lives—speak up. Policy work is slow and incremental but front-line nurses, administrators, educators and researchers all have a role. Now, more than ever, let us remember the words of Martin Luther King, Jr: “If you can’t fly, then run. If you can’t run, then walk. If you can’t walk, then crawl. But whatever you do, you have to keep moving forward.”