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Thank you Maryland, for protecting women's health - again

The Maryland state house, which features loads of historical memorials and statues, is the oldest state house in the country.
The Maryland state house, which features loads of historical memorials and statues, is the oldest state house in the country. (Lloyd Fox / Baltimore Sun)

As an ob/gyn physician and an advocate for women’s health, I am immensely proud to live and work in Maryland, a state that has consistently acted first to pass policy and legislation protecting access to health care for women.

Maryland has not always been my home, and I have had the privilege of living and practicing medicine in several states. When I learned that I matched into the Family Planning fellowship at Johns Hopkins, I packed up my family and moved to Baltimore in 2015. I was excited to become a better surgeon and a better advocate for women’s health.

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During my fellowship, I watched the national political climate shift, as President Donald Trump openly declared his intentions to systematically dismantle reproductive health care access at the federal level. I began to seriously worry about the health and futures of my patients. Fortunately, Maryland legislators have taken it upon themselves to codify protections for their constituents at the state level, and I breathed a sigh of relief. Thank you, Maryland.

First, the Trump administration attempted to repeal the Affordable Care Act and its contraceptive mandate, a game-changer that allowed women access to the full range of birth control options without co-payment or cost sharing. Birth control allows my patients to plan and space pregnancies for healthier babies and to attain educational and career goals. Suddenly birth control was going to get a lot more expensive — and prohibitively expensive for some. In 2016, Maryland became the first state to legislate comprehensive insurance coverage for birth control with the Contraceptive Equity Act. I still worried about contraceptive access nationally, but I felt proud that Maryland was looking out for its women. Thank you, Maryland.

More recently, President Trump took aim at the federal Title X grant program, which funds family planning services, which include contraception, breast exams and mammograms, and cervical cancer screening for millions of low-income women. Mr. Trump added an administrative rule banning Title X recipients from discussing abortion as an option for undesired pregnancy — effectively creating a domestic “gag rule” that limits how I am permitted to counsel my patients about their health. Clinics that rely on Title X grants to serve poor women would be forced to withhold information about reproductive health choices or lose funding for preventive health services.

Again, I worried about the health of my most vulnerable patients, who rely on federal funding for their check-ups and cancer screenings. But Maryland stepped up to the plate again and then knocked it out of the park. With concerns about federal funding in mind, Maryland created a state-funded family planning program in 2017. Last week the Maryland General Assembly passed a measure that would prevent the state’s health department from accepting federal funds that are conditioned on excluding abortion counseling and referrals. I feel fortunate to live in a state that steps up when the federal government prioritizes the religious consciences of its health care workers over the health of its constituents. Thank you, Maryland.

In addition to these examples, Maryland has been a trailblazer on many other reproductive health issues. In 2011 Maryland passed a Medicaid family planning expansion that increased the income thresholds that qualify individuals for reproductive health coverage. In 2018, Maryland became the first state in the nation to pass landmark legislation ensuring the health and dignity of incarcerated women, including access to prenatal care, postpartum care and abortion services. In addition, Maryland is one of only five states that voluntarily provide comprehensive reproductive health care coverage (including for abortion) through their state Medicaid programs. Thank you, Maryland.

Maryland, you have not always been my home, but I feel proud to call you my home now. After completing my fellowship training, I stayed here to serve women and raise my family in this beautiful state. And when the next anti-woman bill comes down the pipeline I won’t worry too much for my patients, because I know I have an ally in this fight. But I don’t take you for granted either, Maryland. I recognize that many women throughout the country do not enjoy the same protections. Now is the time for the rest of the country to step up and follow your bold example.

So, thank you, Maryland, for stepping up and protecting women’s health. Again and again.

Dr. Stacey Leigh Rubin (stacey.obdoc@gmail.com) is a board certified obstetrician/gynecologist and family planning specialist.

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