Two years ago, I was walking on the street during the Kavanaugh hearings and noticed that almost every woman I walked by was glued to her phone; their faces reflected my disgust and my fear for the future. The brutality of the hearings, the callous dismissal of Christine Blasey Ford’s accusations, the general smugness of Justice Kavanaugh and his elected supporters knocked me back in a visceral way. I finally snapped.
I needed to channel that frustration and anger into something productive, so I decided to combine that post-Kavanaugh fury with nearly 20 years of work in reproductive health and develop a program to improve access to birth control in rural and underserved communities.
I went down a rabbit hole of research on models for improving access to such care, and found that in rural communities around the world, mobile clinics are a proven means of delivering care directly to healthcare deserts.
Next, I needed the where.
In 2018, four states—Mississippi, Louisiana, South Dakota, and North Dakota—had “trigger laws,” meaning that if Roe v. Wade is overturned, abortion immediately becomes illegal. More states have since joined them in passing similar legislation. Among them, Mississippi has some of the poorest reproductive health and sexual health outcomes in the nation. In the Mississippi Delta, one of the most rural areas in the state, 62% of pregnancies are unintended and publicly funded clinics are unable to meet 60% of women’s needs for reproductive health care. I reached out to institutions and organizations to understand if what seemed like a good idea in my head—using mobile clinics to increase access to care effectively in birth control deserts like the Delta—would work in the reality of rural Mississippi. I quickly found a community of allies passionate about reproductive health care eager to help launch a new local program in an area where the existing infrastructure is unable to meet the overwhelming need for care.
Two days after Justice Kavanaugh was confirmed, I founded Plan A.
Patients living in rural areas are less likely to receive reproductive health care than their urban counterparts. The nation’s healthcare disparities are particularly stark for women of color. Residents of some small towns are forced to travel far distances for healthcare with few or no public transportation options; telehealth is often unavailable due to poor broadband access. Care is prohibitively expensive for the uninsured, or for those unable to afford their deductibles. The legacy of racial and economic injustice in the healthcare system creates additional barriers to care.
For all these reasons, for the past two years Plan A has focused on residents in the Mississippi Delta. Our conversations with local organizations and community members brought us from an idea into a fully formed organization rooted in the priorities and needs of the community we serve. We are opening our first mobile clinic early next year, expanding services beyond my original plan: the mobile clinic will now offer free birth control from condoms to long-acting reversible contraception, STD and HIV testing, PrEP HIV prevention, and primary-care screening blood pressure, diabetes, cholesterol, depression, and more to uninsured and underinsured residents. And we have plans to expand this program to other high-need areas in the future.
Political change and advocacy often feel like a devastating game of one step forward, two steps back.
Working on issues constantly on the precipice—healthcare, social justice, climate change, education—is emotionally and physically draining. When I founded Plan A, I was driven by what a friend called “divine feminine fury.” Unfortunately, that fury is constantly being replenished, although my anger is coupled with excitement for the impact Plan A’s clinic will have on improving access to care.
The Amy Coney Barrett hearings set off more shockwaves of fear and uncertainty for the future. While politicians litigate the right to reproductive health, women throughout the country face insurmountable barriers to getting birth control. As we rally behind radical change and lobby the new administration, programs like ours will provide essential services to people left out of the conversation. I’m inspired by the momentum created by tangible victories from movements and organizations like Plan A across the country that are improving lives despite the policies crafted to destroy them.
Caroline Weinberg, MD, MPH, is the founder of Plan A Health.