Expanding access to full-spectrum reproductive health care for the uninsured: The Women's Reproductive Health Free Clinic Expansion Project

Lack of health insurance and costly health care are barriers that currently prevent many women from receiving even basic preventative services. In the United States over 17 million women are uninsured, and this number is growing. Since 2004, the number of uninsured women has risen by 1.2 million, and most of this increase has been among low-income women.1 Uninsured women are less like to have a Pap test, fill a prescription or seek other needed medical care. 2

For adolescents, confidentiality further complicates access. Surveys show that adolescents will seek routine medical care with their parents' knowledge.3 However, fewer than 20% would seek reproductive health care such as birth control or STD testing if their parents were notified. Federal laws require that insurers notify policy-holders (that is, parents) whenever teens use the family's insurance. Adolescents need access to confidential reproductive health care without fear of reprisals from parents.

In the United States, Free Clinics (over 800 as of 2007) play an important role in providing primary care to the uninsured. Integrating comprehensive reproductive health care into these facilities would greatly expand access to the populations most in need. Additionally, medical students and residents are rarely exposed to or trained in family planning and abortion, so these clinics, many of which are run by medical students and residents, would fill an educational gap.

This presentation will describe a demonstration project that integrates full-spectrum reproductive health care, including early abortion, into a medical student run free clinic.