My Transnational Contraception Story

Luckily for me and my family, we always had health insurance in my native country. Since the 1940s, Costa Rica implemented a public health insurance system that insures most of its citizens. Even though my country’s health care system has been highly rated, it has flaws that have to be fixed. Nonetheless, I do not remember seeing my family or friends worry about getting sick or going to the hospital because they would not have money to pay the medical bills, they simply went to see the doctor or went to the emergency room. I recall my mother choosing a private gynecologist of her choice to obtain her prenatal care when she was pregnant with my sister. I remember how my aunt got a surgical removal of an ovarian fibroma through the public health care system and did not have to pay any co-payment or deductible. I also remember all my aunts getting prenatal care and delivering without worrying about paying medical bills at the public health care system. As I was still young, I did not need any reproductive health care while I lived in Costa Rica.

After graduating from high school, I got a scholarship to attend medical school in Cuba. My scholarship included health insurance coverage. Before I started to be sexually active, I was able to talk about my reproductive health and contraceptive methods with a family doctor, and was able to choose a contraceptive method without being concerned about paying for it because they were very inexpensive. I remember how I felt uncomfortable with the injection and was able to talk with a doctor about it and simply change to birth control pills. In addition, I could have gotten a legal safe abortion at a health clinic free of cost if I had needed it. There is no stigma attached to abortions, most Cubans consider it another medical procedure, which would have been a relief coming from a deeply Catholic country. I even got an appendicitis surgical procedure free of charge at a Cuban hospital!

My experience with health care had led me to take health insurance for granted and consider health care as a human right. What a shocking experience it has been to come to the U.S. as a penniless international student! It never occurred to me that the world’s most powerful country had a health care system that excludes the most vulnerable populations.

Luckily, I have been healthy in the US up until now, so I have only needed medical care for my reproductive health. However, even getting good quality reproductive health has been quite a challenge. For the first time in my life, I found myself uninsured and worst; unable to even obtain health insurance. Gynecologists are out of the question because I simply cannot afford to pay for their services. I have had to attend community health centers and Title X funded clinics. First, it is hard to get an appointment due to the high demand that these clinics have. Second, perhaps the intersection of my race and class has influenced how I have felt I have been treated at these clinics. Sometimes I have felt as if I am asking for handouts or that staff has a patronizing attitude. Once, I was not able to obtain the birth control pill of my choice because its price is unreachable for me ($90/package).  Overall, I am barred from getting good quality reproductive health due to my immigration status and social class.

My experience may point out to a system failure rather than an individual experience, the overstated fact that people of color, especially immigrants, have unequal access to health care.  I am not the only person struggling to get good quality health care, many Latinas, whether U.S. citizens, legal permanent residents or undocumented women, lack health insurance or received limited health care services.

Statistically speaking, Latinos are an under-served community disproportionally affected by laws and policies. The community is rapidly growing and in 2006 accounted for almost 15 percent of the total U.S. population.

The list of sexual health care disparities of Latinas could be longer; however, this short list illustrates Latinas’ disproportionally lack of good quality reproductive health care and how even though most Latinas are foreign-born policies have prevented low-income immigrant Latinas to get to health care.

  • In 2007, there were 30.1 million adult Latinos in the country, and adult Latinas made up 48 percent of them.
  • It is estimated that about 52 percent of Latinas were born in countries other than the U.S.
  • In 1996, the federal government passed a law that prohibits legal immigrants to obtain Medicaid and Medicare coverage during the first five years of U.S. residency, and undocumented immigrants are ineligible for Medicaid excluding for emergency services.
  • The recent signed into law health care reform prohibits undocumented immigrants from buying health insurance policies out of their pockets in the exchange system.

As reproductive justice advocates, let’s continue having an active role working to decreasing health care disparities to ensure that our community gets better and more health care access. During this week of action, let’s get renovate our energy that there is a lot to get done!

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  • elizaann

    I’ve had all of the experiences you mention here (and some worse).  I’m sure that being of a different race can render you more susceptible to even more discrimination, but this is a class issue more than a race issue and to be frank, it scares me that you would work on improving health care for Latino women or African American women or any other color while ignoring poor white women who are facing the same issue.  I’m not commenting on this to be angry or mean.  I’m genuinely in the same position you are and you’re ignoring that.

  • zenith15

    I agree completely with ElizaAnn. I am a low income white woman and have experienced all these problems and more.  I don’t believe I have ever received health care over a minority based upon my race.  The USA allows over 40% of it’s citizens to go without coverage for health care, and programs for the very poor require you to be SO poor that it disqualifies anyone with any kind of a regular job. For example, in my state, a family of four must make less than $800 a month to qualify.  If you make, say, $900 per month, you are assumed to have plenty of money to pay completely out of pocket for all your family’s medical, surgical and pharmaceutical needs. 


    My husband needs a liver transplant. He has worked hard all his life, but unfortunately not for an employer with more than 12 employees–therefore the employer was not required to provide insurance.  When he became to ill to work, we applied for disability. He was turned down twice, which is the usual procedure, and we had to hire an attorney who got a large cut of the “back pay” when he was finally approved–this is also standard procedure.  During this time, of course, he could not work and we had almost no income as he needed care. 


    Once it was finally approved, we learned that the automatic Medicare coverage that came along with SS Disability, was withheld for TWO YEARS.  During this time of course he could not work, and could not get private insurance due to his preexisting condition. The ONLY option for coverage was to take out a policy with the state High Risk Pool. That policy covered ONLY catastrophic care, cost $800 per month, and did not pay for medication, doctor visits, or any general care.  Oh, and it had a 5,000 dollar deductible before it would pay for ANYTHING AT ALL. 


    The hope is that you will die before the two years elapses. Unfortunately for them, he made it, and now has medicare and is finally on the list for a liver transplant.  However, many other people don’t make it through all that. 


    And every day, mothers with children who have an easily treatable respiratory infection, ear infection, etc must go to the overcrowded county ER and wait for many hours to finally be seen by overworked staff who display their anger at them for not going to “your primary care doctor”. Of course, they have no insurance and so cannot go to a regular doctor, so instead they must use the ER, and owe thousands of dollars for what could have been a $40 office visit, thereby ruining their credit and setting them up for years of harassment by collection agencies.  And then they STILL cannot afford the prescriptions they get. 


    THIS is how it is for all of the poor to middle class uninsured in the USA–not just Latinas. 

  • arekushieru

    Just to clarify before I continue:  I am a single white woman born of middle-class parents.  However, I fall far below the poverty line.  Now that I’ve got that out of the way ( ^_^ ):

    Yes, but I think you’re both missing the point.  The majority of women who are impoverished do hail from visible minorities.  But, due to the discrimination you mentioned, these women often get ignored.  Sure, there may be instances where a poor, white person may encounter the same circumstances as a poor, non-white person, but they most likely are rarer occurrences.