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Ding Dong! Door to Door Depo

December 16, 2009

Photo by Planned Parenthood Federation of America

I came across this post yesterday on the Global Health Magazine Blog.  It’s from Planned Parenthood, about work they’re doing to improve contraceptive use among indigenous youth in Ecuador.  Trained rural, indigenous youth are (are you ready for this?) providing Depo Provera (a birth control shot) outside clinic walls, in the community, to other youth.

At first I was like, “say wha?” but then I realized it’s ingenious.

Do you remember how hard it was to first get your hands on pills or condoms when you were a youth (or if you still are)?  Well then multiply this by the fact of being in a particularly conservative society where youth and sexual health and rights just aren’t ever in the same sentence.  Then add to that the fact that indigenous communities are notoriously underserved and health literacy is often really low.  The young people getting new contraceptive access with this very cool program simply wouldn’t be getting it otherwise.  Access: success!!

I love the idea of giving the power to the people by moving reproductive health services outside clinic walls.  I think that model perfectly embodies what reproductive justice is about: letting each individual reclaim the rights and agency to his/her body.

This is what is so cool about community-based models of reproductive health work.  It’s a simple but radical approach to realizing reproductive rights: train and empower the individuals who most need the services to offer them themselves.  I actually wish someone would show up at my apartment door right now with a NuvaRing.  Alas!

One thing that is so suffocating about reproductive health care in the U.S. is how medicalized and bureaucratic everything is.  If you need a simple pack of pills, you have to schedule a $300 appointment with a provider just for them to hand over a prescription, that you’ll end up waiting an hour in line at Duane Reade to fill.  Argh.

The model that Planned Parenthood is using is definitely not something that would fly in the U.S., but perhaps it’s something we can aspire to.  When/if the public option becomes a reality option, maybe then we can think even bigger about how reproductive health services can be even more accessible.

5 Comments
  1. December 16, 2009 1:14 pm

    Hmm. I actually have some reservations about the emphasis on Depo-Provera. Depo-Provera can have a serious negative impact on bone density leading to osteoporosis. It also differs from other birth control methods in being something that a woman cannot simply decide not to use one day, so I worry that this is less about giving these young women more reproductive freedom and more about discouraging them from reproducing because they are considered undesirable.

    It reminds me of the distribution of Norplant and Depo-Provera in poor communities in the US (see http://www.msmagazine.com/apr01/roberts.html).

    On the other hand, I do understand that injections may be more convenient for some women and help to maintain privacy, so I’m not sure that that’s what’s going on here.

    • Jessica Mack permalink*
      December 16, 2009 1:53 pm

      I do see your point about Depo, but it’s also true that every contraceptive method has its drawbacks. That said, the article states that it’s not JUST Depo that these youth are providing. They also offer pills and condoms — so it really is the individuals’ choice. They can also refer a client back to a clinic where they can get even more options. I work in a reproductive health clinic where lots of teens choose Depo for a range of reasons — sometimes they’ve really researched it, and sometimes it’s simply because their friend uses it. Giving women choice is about truly letting them choose — and using whatever criteria they want, as long as they’re as informed as possible.

      With regards to contraceptives in underserved and oppressed places…well there’s always the specter of terrible programs that disregarded women’s rights and pushed contraceptives as a mode of control, rather than something enabling agency. I, for one, believe this is 100% NOT what Planned Parenthood is about. I read this and thought power to the people, not power from the people. Thanks for your reaction!

  2. Lexi Bradley permalink
    December 19, 2009 3:31 pm

    I agree with the first response. This reminds me of the Depo-Provera injections of Native American populations and other minorities by the U.S. government. A lot of these women did not even know what they were consenting to, if they consented at all. And Depo-Provera has tons of nasty side affects.

    I do like the idea that these people have easy access to birth control. I feel that is absolutely a form of liberation. However I just hope that they aren’t sterilizing native populations as a form of “population control” like the US has done in the past.

    • Feminist Fanny permalink*
      January 7, 2010 1:16 pm

      I can say with absolute authority that there is no “population control” tilt at all! Planned Parenthood works entirely from a rights-based perspective. There is no sterilization here, we are talking about family planning. It’s understandable to be wary of family planning programs in developing countries given the sordid history of some policies in the ’60’s and ’70’s, but I worry that both of you have been out of the loop for…um…several decades. There is an entirely different approach to reproductive health and rights these days being championed by feminist organizations such as Planned Parenthood, International Women’s Health Coalition, Ipas, etc. Just because something bad happened ages ago, doesn’t mean there hasn’t been important learning and changes!

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