Civic Matters

A Catalyst for Community Dialogue

Issue 1, October 2007

Not Just Abortions

Laura Severance

Prior to my Praxis III independent study experience, the mention of Planned Parenthood conjured up images of pregnant teens seeking abortions and promiscuous adolescents clamoring for birth control. I viewed Planned Parenthood as a service provided to young women in poor communities, but I was unaware of the quality of care and resources offered. Planned Parenthood Norristown seemed like a good venue to examine underprivileged women’s reproductive health choices, so I chose to pursue a placement there. For the duration of my fieldwork commitment (one full day each week during the fall 2006 semester), my responsibilities included taking Spanish-speakers’ medical histories and administering pregnancy tests and emergency contraception.

Part of what attracted me to Planned Parenthood Norristown was my knowledge that the clientele would be very different from me. Coming from a white upper-middle class background, I was curious about the life experiences of women from poorer and more racially diverse communities. At first, I was concerned that the clientele might perceive me as a “rich white girl” who was trying to tell them what to do. However, these concerns faded as I began seeing patients, because I realized that I was simply providing them with services they asked for. They wanted information or medication, and I was providing this — not value judgments. There were times when I wanted to speak my mind, but I knew it would be inappropriate to do so. For example, a 14-year-old came in for a pregnancy test and was devastated when the test was positive. Nonetheless, she insisted she wanted to keep the baby. I couldn’t fathom having a child at 14 — this would have surely altered the trajectory of my own life. However, it is crucial to respect patients’ decisions, and I appreciated the opportunity to talk to women whose lives and choices were very different from mine.

Naturally, I felt uncomfortable at times. For example, for fee assessment purposes I asked one woman about her living situation, and she replied, “I live with my babydaddy.” I then proceeded to ask, “So how much does your boyfriend make?” Unbeknownst to me, this was quite a faux pas, because she went on vehemently to deny that her “babydaddy” was her “boyfriend.” Looking back, it was foolish of me to assume that they were one and the same, but that was my immediate thought. Another somewhat amusing anecdote concerns my experience with one of our male patients. He came in for treatment for Chlamydia (which he had contracted from his “two-timing girlfriend”) and was told that he couldn’t have sex for seven days while on the medication. His reply to this news was, “That’s okay, I’ll ride my dirt bike instead and it won’t cheat on me or give me problems.” While sexually transmitted infections (STIs) are a serious matter, I had to try hard not to laugh at his choice of words. There were also times when I was surprised at women’s misperceptions regarding reproductive health. For example, when I offered the morning-after pill to one woman, she asked me if that was “one that kills your baby once it’s inside of you.” Answering questions like that in an appropriate way was a challenge for me.

Another aspect of patient behavior that I found fascinating was self-presentation. That is, I believe that patients were trying to present themselves in the best light possible (as we all do), regardless of whether or not this was reflective of their reality. For example, people would come in for STI treatment, which is a clear indication that they don’t use condoms with every act. Nonetheless, they would answer “yes” when I asked, “Do you use condoms consistently?” Of course, I could see through their answers, but they lied to me anyway. While this “saving face” behavior is natural, I felt that it jeopardized their healthcare at the same time.   

Perhaps the most important thing I learned during my time at Planned Parenthood Norristown concerns my assumptions regarding the nature of the clientele population. While most women were not college educated and financially privileged, some were (I treated a janitor and a law student on the same day). Patients cannot be lumped into a category as “poor uneducated women.” I think it is dangerous to think of a population as homogenous, especially in the medical profession, because this may cause one to treat every client the same way. However, these women have different problems and respond better or worse to certain kinds of communication.

My experience at Planned Parenthood Norristown was an enlightening one for me in many ways. Primarily, it gave me a new perspective on reproductive health. I found it beneficial to compare my own attitudes towards reproductive health with those of a different population. Also, I found it refreshing to have contact with people outside of the “Bryn Mawr bubble.” Furthermore, the experience provided insight into how a non-profit organization works, as well as how a doctor’s office works. I was impressed by the range of services and quality of care that Planned Parenthood provides. Despite their limited funding (they receive approximately $20 per patient per year from the state — a shocking figure when you consider the staggering cost of medical care), Planned Parenthood provides comprehensive care in a way that is sensitive to patients’ concerns. Planned Parenthood isn’t just about providing abortions for marginalized members of society. It’s about ensuring that women have access to good reproductive healthcare, a service I feel greatly contributes to all women’s well-being.

Laura Severance ’07 earned her A.B. in psychology. She enjoyed her time at Bryn Mawr and is looking forward to graduate school in industrial-organizational psychology.