On March 30, 2016, Donald Trump stated that women should bear “some form of punishment” for seeking an abortion if it were illegalized. On Oct. 26 of that year, I got an intrauterine device inserted by Barnard Primary Care Health Service, and less than two weeks later, Trump was elected president of the United States.
Since then, Trump’s administration and Republican legislators have made many attemptsat restricting reproductive rights in this country, such as the so-called global gag rule blocking federal funds from organizations around the world that even mention the word “abortion” and House Speaker Paul Ryan’s promises to cut funding for Planned Parenthood. Considering all the frightening ways the Trump administration has threatened millions of Americans, I found myself wondering what an institution like Columbia should be doing to protect its students.
As undergraduates at Barnard and Columbia, we rely on our administration for a host of services: food, housing, internet, coffee, tampons—and, for some students, birth control. And, as we make Morningside Heights our homes for four years, we often come to expect the University to defend access to these resources.
I had been getting the Pill through Barnard Primary Care Health Service for years, and it was always a simple operation: I had my blood pressure taken, answered questions about my sex habits, and then the nurse practitioner would hand over a six-month supply of my fix in a doggy bag, as though it were some covert exchange. I would proudly carry the white, wax-lined paper bag across campus as though it held nothing but a bagel from Liz’s Place.
But due to my wildly inconsistent schedule, I was constantly forgetting to take my pill on time, and by senior year, I realized that I could make the process even easier by getting an IUD from Primary Care. I felt liberated by the ease with which I was able to book my appointments and get the care I wanted. And after Nov. 8, 2016, after which the number of IUD insertions at Planned Parenthood increased astronomically, I felt very thankful that it was so easy and—perhaps more importantly—free under the Affordable Care Act.
Birth control management has “always” been within the top five diagnoses in the year at Barnard Primary Care, at least according to Mary Joan Murphy, who has been the executive director of student health and wellness programs at Barnard Primary Care since 2012. When a student logs onto the Open Communicator website to make an appointment, there is a specific drop-down menu option to book a 20-minute contraceptive management appointment for current or restarted contraceptive prescriptions or for pre-IUD medical clearance.
Barnard students also have access to contraceptive support in the Well Woman office, which promotes health and wellness for students. (They’re the ones that put free condoms outside their office in the Barnard Quad.) Well Woman peer educators offer advice and support on issues like birth control, and are available as “IUDoulas” for students getting IUDs inserted at Primary Care.
But while birth control is clearly popular, Murphy points out that students don’t always seek out hormonal birth control for contraceptive use—some use it to regulate their periods or control acne. But executive provisions stripping Planned Parenthood funding or repealing Affordable Care Act coverage won’t discriminate between these groups—everyone comes up short.
Columbia Health also boasts a wide range of birth control options. Roseann Neuberg, a nurse practitioner at Columbia Health Services, says they provide “the whole gamut,” from condoms to the Pill to arm implants and IUDs.
Both Barnard and Columbia health services explain that, at least anecdotally, their patients seem to be acting more urgently to get long-acting forms of birth control. Long-acting reversible contraception, or LARC, refers to types of contraception like the IUD and hormonal arm implants. Last academic year, the Columbia Health inserted 357 IUDs. As of March 19 this year, with six weeks left in the semester, they’ve done 334—a number tracking slightly higher than normal.
Murphy explains that LARCs have been becoming more common in the past few years for several reasons: They’re free under the Affordable Care Act, and they’ve been promoted by clinical organizations such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists as the best and most effective method of contraception, especially for adolescents.
So while LARCs have been growing in popularity for several years—Barnard Primary Care has been offering insertions since 2015—Murphy notes that there has definitely been a change in public perceptions toward them recently, namely since the November elections.
“It was gaining momentum. I think it’s now hit crisis mode,” she says. Murphy also cites the statistic that IUD insertions at Planned Parenthood have increased 900 percent since Trump’s election, a rush that I seemed to have missed by only a few weeks.
Neuberg also states that in her relationships with patients, she has noticed that they seem like they feel more pressured to act now. “It’s actually a win-win,” she says, since LARCs are the safest and most effective methods of birth control on the market.
“So despite the political climate, more women are accessing and utilizing more effective forms of birth control,” Neuberg remarks.
Students away at college are often far from their doctors at home, and with busy and fluctuating schedules, it can be difficult to travel far outside the Columbia bubble for birth control.
Agnes Carlowicz, a Barnard senior, had an IUD inserted by her gynecologist at home in New Jersey, but due to health complications with it, she also relies on getting hormonal birth control shots every three months at Barnard.
Though Carlowicz describes less than pleasant experiences going through Primary Care, she still says she would continue using Barnard for birth control. “Just because it’s easier—I don’t want to have to pay a copay somewhere,” she explains. “It’s right here, it’s such a fast procedure.”
While Carlowicz was the only one I talked to who had a negative experience at Barnard Primary Care, I was disheartened by her story, especially since it contradicted all the great experiences I’ve had at the clinic. I wondered if I was the outlier, or if she was.
When I talk to Kathleen Duffy, a postbac student at the School of General Studies graduating in May, I find much more optimism about Columbia’s health services. Duffy is 26, meaning that she is no longer on her parents’ insurance plan and relies on Columbia’s Platinum Plan for access to the pill.
Duffy explains that she has been on birth control since she was 19 or 20, so she knew exactly what she needed when she arrived at Columbia. This made the process at Columbia Health much simpler for her—as opposed to with Carlowicz, who has had to balance two kinds of birth control and deal with doctors both at home in New Jersey and at Barnard.
“[The nurse practitioner] was just very friendly, and it was incredibly laid-back but professional,” Duffy says. “I didn’t feel uncomfortable; everything was positive.”
I wonder whether Duffy’s age and past experience with birth control also makes her more confident in accessing birth control in the wake of the Trump election; it’s a confidence I lack.
“I don’t really feel like my reproductive rights have been infringed upon directly. I think that what Trump and his administration and his supporters are saying is one thing, but I haven’t felt that in my own daily life,” she maintains.
I ask Duffy if she’s worried about the future of reproductive rights in this country, and her answer conveys a refreshing sense of optimism: “I think that it would be fine ... especially since we’re in New York, as a more liberal state,” she says. “And I think large administrative changes like this bizarre interest in making access to abortions more difficult … will take an incredibly long time, and I can only hope they’ll die in the process.” Our interview took place before the March 24 death of the GOP’s Obamacare repeal bill, and looking back at Duffy’s response, I feel a surge of her morale in myself.
Murphy reiterates this reassurance, saying that New York residents are fighting to get cushioned by state requirements set on top of the ACA, citing in particular the Reproductive Health Act and the Comprehensive Contraceptive Coverage Act that are waiting to get passed. “We’ll be protected in this state,” she says.
But, looking outside the Columbia bubble, not everybody has the same protections. “It’s the states that have—and I don’t mean to get political—more conservative, usually Republican legislatures, that disregard that, which is a problem,” Murphy clarifies.
What I’ve learned for certain is that the future of reproductive rights is uncertain, especially for graduating students who won’t be living in a progressive state like New York after they leave school, or using a college health insurance plan. So what exactly do students expect from their administration while they’re here?
When I pose this question to Carlowicz, I reference the emails students have received from University President Lee Bollinger, former Barnard President Debora Spar, and Interim Barnard President Rob Goldberg about new and frightening restrictions on human rights—such as Bollinger’s response to Trump’s March travel ban, which he wrote “seriously interferes with the University’s commitment to participate in the international exchange of information and ideas.”
“As a human who has reproductive organs that are in need of particular services … in the same way I think that Counseling and Psychological Services are imperative, I think health services are imperative for the University to focus its money,” Carlowicz says.
But when I ask Duffy the same question, her answer is slightly more tentative, as she searches for the right way to articulate her thoughts.
“It would be really hard, I think, for them to do it,” Duffy says in reference to the administration making a public statement in support of reproductive rights. “You’d have to be careful, just like I’m sure they were very careful with the way that they came out against the executive order [on immigration].”
Carlowicz, on the other hand, is more confrontational about Columbia’s and Barnard’s responsibility to their students. “As a University that, ‘prides’ itself on putting marginalized groups first,” she says, “one of those groups is people with uteruses.”
“It’s not an even playing field, right now. It never has been,” she adds. “I think it’s important that Columbia and Barnard work toward that.”
Murphy echoes Carlowicz’s sentiment about the model that Barnard and Columbia should be when it comes to accessing women’s health resources—she says that Primary Care must make decisions based solely on what the patient needs, rather than what the government thinks.
“I think as a women’s college, we need to set the example of that,” Murphy says. “So we have to practice what we preach.”
Representatives from both Columbia and Barnard health services make sure to stress that they do plan to continue providing students with birth control in the foreseeable future. Brenda Aiken, the director of Columbia Medical Services, says with regard to new concerns about birth control, “It’s a conversation that we’re having with our patients, and we’re happy to have the conversation, regardless of the reasons [why].”
Murphy is also very certain about the future of contraceptives for Barnard students. “The health center at Barnard will always provide contraception, and no matter what barrier we’re faced, we will go around it, go through it, go over it, to make sure that we meet the health needs of our students,” she says confidently.
Hopefully, by October 2021, when I have to get my IUD replaced, our government will have discontinued its obscene fascination with my reproductive choices. I hope I’ll be able to go to my gynecologist or to Planned Parenthood and get it done for free. And although I’ll be long gone from this campus, I hope Columbia’s health services will go on providing adequate birth control services to students during what looks to be a turbulent time in the future of reproductive rights.
And while Bollinger insists that the University not take stands on ideological or political issues, I expect Columbia to continue to step forward when state and federal policies conflict with its fundamental values. In the meantime, we can continue fighting for our rights and donating to Planned Parenthood under Mike Pence’s name.
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