This is the United States of America.
You know….that beacon of freedom for the entire world.
That bastion of excellence in everything. The country that likes to think it sets the standard.
So you might think that when you go to a medically-trained doctor or nurse seeking to have your IUD adjusted, the fact that they were trained and certified as medical professionals in a field with clear standards and the fact that you live in a democracy that prides itself on leading the world in human rights (or used to) your wish simply to have the small problem you are experiencing with your IUD fixed would be respected.
You might be wrong.
Now, apparently, some nurses, doctors, physicians assistants and other providers feel empowered to decide for you whether contraceptives are ok, which ones, if any, you are allowed to use, and when you will stop using them irrespective of your wishes. Not because of any medical reason. Just because that particular provider does not like that particular method. Or any method of contraception. Or maybe anything having to do with sex or sexuality. It’s enough that s/he just does not like your choices.
This kind of situation has been much-discussed as a potential outcome of the new HHS rule to go into effect on Monday, January 19th. But possibility and reality have already collided head-on in the story of a New Mexico woman whose IUD was removed by a nurse against the woman’s wishes and who is now suing both the nurse and the center in federal court for battery, constitutional violations and
The patient went to the Presbyterian Health Services Rio Rancho Family Health Center in Rio Rancho, New Mexico, and saw nurse practitioner Sylvia Olona. Her request: Simply to shorten the strings on her IUD for greater comfort.
The result? Nurse Olona took it upon herself to remove the troublesome device. Why? Simple, Nurse Olona told her patient:
"Having the IUD come out was a good thing [because] I personally
do not like IUDs. I feel they are a type of abortion. I don’t know how
you feel about abortion, but I am against them. …What the IUD does is take the
fertilized egg and pushes it out of the uterus."
Hmmmm….funny….I don’t think they teach this definition of abortion in medical or nursing school. But in the free-for-all, define-your-own-medical-practice era of reproductive politics of the past 8 years, anything apparently goes. Nurse Olona could instead, with respect for herself and her patient, easily have said "I can’t help you with your IUD as I am uncomfortable with this form of contraception, but let me get you someone who can."
But no. The patient’s own choices became the subject of a morality play inside the walls of Rio Rancho. The federal complaint states:
"As soon as Defendant Olona began speaking to (the
plaintiff), she questioned her about her choice of contraception.
Defendant Olona began the procedure, (the plaintiff) felt Olona pull on
the strings of the IUD. (The plaintiff) felt a distinct pulling on the
strings followed by a sharp pain in her uterus similar to a very strong
"As that happened, Defendant Olona stated, ‘Uh
oh, I accidentally pulled out your IUD. I gently tugged and out it
came.’ She then explained, ‘I cut the string than went back and gently
pulled and out it came. It must have not been in properly.’
In true Britney Spears’ "oops I did it again" style, Nurse Olona stated:
‘Everyone in the office always laughs and tells me I pull
these out on purpose because I am against them, but it’s not true, they
accidentally come out when I tug.’
Nurse Olona, don’t be so coy….! Just repeat what you told your patient:
Olona told (the plaintiff) that it was better that she did not have the
IUD because she could now use a "non-abortion" form of contraception.
Defendant Olona suggested the deprovera (depo) [sic] shot or the pill,
and made clear that she would not insert a new IUD."
As noted by Cristina Page today, and has been extensively documented elsewhere on Reality Check, unless we get a quick injunction against the recently formalized and nonsensically named HHS "provider conscience rule," these types of stories may become more and more frequent.
But what worries me is that this is happening now. Before the HHS rule is actually in effect. And may be happening frequently, with or without provider conscience rules, under the radar screen. What this suggests to me is that even once we get rid of the new HHS rule–and we are all depending on the new Administration to do this as quickly as possible even with an unjunction–we need a new strategy, one which new HHS Secretary Daschle and the new Surgeon General must take on as soon as possible….issuing or re-issuing clear guidance to all medical and nursing professionals about the science and medical definitions of contraceptives and abortion; about the fact that contraception is not abortion and that contraception reduces unintended pregnancy and the need for abortion; about the fact that abortion is legal in the United States of America; and finally that patients rights to privacy and informed choice and consent still mean something in this country. Finally, we need a public discussion about the limits of power of individual medical practitioners to take women’s reproductive lives into their own hands.