For women during lockdown, accessing reproductive healthcare poses new challenges

The goal had always been to start an online health center. But Planned Parenthood of Southwest and Central Florida didn’t have it on the books for this fiscal year.

Then, the coronavirus hit. And over the course of six weeks, they set up a destination where local clinicians could see local patients virtually, said CEO Stephanie Fraim.

Fraim said when it became clear what a risk the coronavirus posed, Planned Parenthood had two missions: to keep staff safe and to continue providing as much care as they could. Online or telehealth appointments helped serve patients without requiring them to come to an office. Three offices in the region were closed, in the event another office became infected with the coronavirus and they’d need a backup. Existing appointments were spaced out, so only one person was waiting in the lobby at a time.

The online health center will exist after the pandemic — it helps the clinicians give care in communities away from the physical buildings, like in rural Polk and Hillsborough County.

“We can now reach into corners of our territory that have been difficult for us to get,” Fraim said.

Planned Parenthood expanded to using telehealth nationwide for the pandemic. Previously, about half of the states had some online capacity, but the new expansion means people everywhere can access a wider array of services.

In Florida, Planned Parenthood has continued to schedule and perform abortions. Before the pandemic, incoming patients could bring someone along — a partner, a family member, a friend. Now, that person would have to wait in the car.

“It is the single hardest change we’ve had to make,” Fraim said.

Currently, in 13 states but not Florida, a program called TelAbortion offers women a consultation with a doctor, then mails them the pills necessary for a medication abortion, according to the New York Times.

One of the big concerns for Planned Parenthood, and other women’s-focused groups, is that women may not be able to answer honestly or reach out, because they’ve been quarantined with abusers or other people who would restrict their access to care.

When a patient calls to set up an appointment, there are standard, longstanding screening questions. But now, there’s a second screening when someone comes into the office, Fraim said.

“We’re acutely aware that if your abuser is sitting next to you, you can’t answer honestly,” Fraim said.

She also said the online services may help victims of intimate partner violence access care discreetly, or help minors at home with parents who may be in need of private services.

“We’ve been thinking about this from the very beginning,” Fraim said. “It’s not a perfect solution, but it’s a solution.”

Amy Weintraub, the reproductive rights program director at Progress Florida, said they are concerned about all people having access to reproductive healthcare during the pandemic, but especially those living with abusers.

She said teenagers are at particular risk, because their access to birth control, often through schools or clinics, has been removed, though Weintraub added she hopes that they would be practicing social distancing regardless.

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They’re also under the closer eye of their parents. Weintraub called around to about 40 county clerks of court to ask if they had a protocol in place for judicial waiver of parental notice for abortions. In Florida, minors have to give their parents notice, unless they file a form with the county that explains why they cannot.

All the clerks who responded said they had a process in place. The waivers, even before the pandemic, are not common. In Pinellas County, 13 were filed over a year. In Hillsborough there were 11. In Pasco, only four.

Still, Weintraub said even though women’s healthcare centers may still be providing appointments, the nature of the lockdown would make it harder for women to get the care they need.

“When transportation is limited, when you can’t take a bus because the bus system’s closed because of virus risk, or when you can’t travel because you’re supposed to stay at home and you can’t cross state lines or what have you, that means that women don’t have access,” she said.

There isn’t a hard date for when the other Planned Parenthood centers may re-open. Fraim said they’re taking it day by day and still encouraging their staff to take isolation seriously so they can keep helping the patients who come in.

“Our slogan is care no matter what,” Fraim said. “We have lived that in the last eight weeks in ways we never dreamed possible.”

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