I was invited to an event at the end of October called, “We Hear You Girl! A Community Conversation About Women's Health,” hosted by Alabama State Reps. Marilyn Lands (D-Huntsville) and Terri Collins (R-Decatur). Billed as “non-political,” the event was open to women only and aimed to generate conversation to help elected representatives understand the issues surrounding women's health care from the citizens’ perspective. The stated goal was to discover ways to better serve the families in their districts.
“I think it's a listening thing,” Collins said, “and so we want to hear kind of what people in our community are saying.”
“Maternal health care outcomes and presumptive eligibility,” as well as “the intersection of mental health and education” were what Lands said she was focusing on.
I find getting health care in Alabama overly complicated, so I was intrigued to hear other women’s experiences. As a journalist, I was also curious about how these elected women from polar opposites of the political spectrum would manage to facilitate this discussion.
In 2023, the Commonwealth Fund gave Alabama a score of 43 out of 51 in women’s health outcomes. Alabama also has one of the highest infant mortality rates (7 in every 1,000 births).
The Alabama Department of Public Health notes that the highest percentage of uninsured are among 18-24-year-olds. On the one hand, this is typical of this age group in any state; on the other hand, these are reproductive years for women, where proper care can make a difference whether one plans to bear children now, later, or not at all.
The conversation involved group-selected topics including pro-life, pro-choice, maternal/infant mortality, affordable health care, and mental health. Then we organized into the five subject groups for discussion, after which we reconvened and shared group summaries. The goal was not to find answers or form conclusions, but to air and hear the topics, beneficially learning from differing viewpoints, and many of us signed up for further information and discussion on the topics that resonated with us.
One issue I found is that if you are going to discuss women’s health care, then abortion and in vitro fertilization (IVF) has no place in it. One is about terminating life, the other is about manipulating the natural processes that produce life. These procedures are costly, both morally and financially, but my biggest complaint is that they drain resources from the care many Alabama women need and support: pre- and post-natal, infant mortality, and menopause care.
Because of the national election, abortion and IVF were used by the left as cudgels, but most Alabama women are concerned with neither. The IVF nonsense passed by the legislature was simply a sop to the donor class: i.e., the doctors and IVF centers who came under fire (rightly so) after the Alabama Supreme Court decision.
It is interesting that Collins is sponsoring a bill (HB237) that will shield IVF providers from civil and criminal liability in the event of death or damage to an embryo. The average Alabama women cannot afford IVF procedures, so this legislative rush to help providers (while disregarding the women harmed) has little to do with women’s health, and everything to do with the monied and well-heeled.
My next issue: Health care and health insurance are intertwined, and this should not be the case. Clearly, powerful interests in state government enjoy money and power from this status quo.
There seems to be no room for crafting health care that doesn’t require an insurance provider. Another bill that Collins sponsored (HB310), seeks to establish tax credits for donations to rural hospitals. While this is a worthy aim, deepening the symbiotic relationship with corporate medicine to the exclusion of other forms of care (mobile, alternative) makes it difficult for women who are relatively healthy, extremely busy, and just want regular maintenance without the complications. Unless there is a more focused problem found during that maintenance, most women want to be left alone to live their lives, not hampered by long wait times, unnecessary procedures, and the push for pharmaceuticals to the exclusion of all else.
If health care was clear, straightforward and accessible, then more women would probably do it, and health outcomes would be better. Requiring insurance hampers this. I carry insurance, but prefer to pay for maintenance visits independently. This seems to befuddle the Alabama medical providers I have encountered. They automatically assume that it’s an affordability issue, when it’s really about portability and practicality. When I pay the cost, I can choose the procedures I want, and not jump through a convoluted insurance matrix. The fact that every medical provider and staff assistant with whom I’ve interacted had no idea how much a procedure costs outside of insurance is appalling. I have also been billed for procedures that I already paid for in cash, showing the autopilot nature of an industry that exacts excessive and unnecessary costs, but provides little in terms of actual care.
My last issue is the lack of holistic and alternative medicine. Alabama’s failure to ensure alternative medicine and holistic care is just as accessible as mechanical or pharmaceutical means is telling. I was told by one attendee that until 2019, midwives and doulas were not even certified to practice in the state! It is also strange that neither Lands nor Collins are involved in a bill that would help refine the laws surrounding midwifery (HB312). If Lands says she cares about “maternal health care outcomes,” you would think that she would be deeply involved with ensuring all the options for better outcomes are available. Part of the issue with infant mortality involves a lack of pre-natal and emergency care in rural areas. Having midwives in these communities would ably fill those gaps.
I worked in the holistic world for over a decade in California, so it is disheartening that I must travel to surrounding states and even back to California to take advantage of alternative options. Aside from a handful of nutrition stores and naturopaths, options are few and far between. But minute clinics, pharmacies and “wellness” centers that are just repackaged standard medicine are in abundance.
So why is there still a health care crisis? This is difficult to assess with just one conversation. The first conversation should have been reimagining what comprises actual health care. Alabama needs to recognize that maximizing women’s health involves more than insurance, standard medicine and pharmaceuticals. Diverse options and the encouragement to use them will ultimately translate into more positive women’s health outcomes.
Jennifer Oliver O'Connell, As the Girl Turns, is an investigative journalist, author, opinion analyst, and contributor to 1819 News, Redstate, and other publications. Jennifer writes on Politics and Pop Culture, with occasional detours into Reinvention, Yoga, and Food. You can read more about Jennifer's world at her As the Girl Turns website. You can also follow her on Facebook, Twitter, and Telegram.
The views and opinions expressed here are those of the author and do not necessarily reflect the policy or position of 1819 News. To comment, please send an email with your name and contact information to Commentary@1819news.com.
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