While despair is often the reaction to misguided Texas women’s health policies, the Dallas-based Institute to Fight Child Poverty has scored another victory with a practical reproductive and maternal health initiative that everyone can agree on.
The solution is clear when we look at the facts.
Many Dallas County women become pregnant before they are ready to start a family, and the county’s teen birth rate is 23.2 per 1,000, higher than the state and national averages.
Many local women attend community college, but 70 percent don’t have access to the contraception they want; Dallas College only provides condoms and referrals.
CPAL aimed to remove barriers: What about bringing birth control options and other women’s health services to community college campuses, purchasing and deploying mobile clinics to make access quicker and more affordable?
That may sound simple, but don’t think it’s easy: After five years of hard work with partners Dallas College and Parkland Health, CPAL introduced the shiny pink and purple Women’s Wellness Bus this month.
With Texas banning nearly all abortions, the work of CPAL’s reproductive and maternal health division, the Trust Her team, is more important than ever.
Kate McCollum, a leader of Trust Her, told me the idea for the mobile clinic began with a 2018 report from the University of Texas at Austin showing that financial barriers and limited access to health care providers meant that female community college students had limited access to effective contraception.
The survey found that women used condoms and birth control pills, even though they preferred more effective methods such as IUDs and oral contraceptives.
“We’re filling a gap with this project,” McCallum says. “The data and evidence show that access to contraception is an area where Trust Her can make progress, and one where there is a lot of momentum and excitement in these divided times.”
The mobile unit will travel to UT Dallas’ seven campuses and provide services such as contraception counseling, STI testing and sexual health education.
It’s part of Trust Her’s efforts to ensure all women in Dallas County have same-day access to any form of birth control, regardless of their ability to pay. The effort also includes partnerships with 20 clinics, a number McCollum expects to grow to 35 by the end of the year. (More birth control resources can be found at trust-her.org.)
The mobile clinic, which resembles a camper, will have two exam rooms and will be staffed by Parkland’s team of caregivers, a financial counselor and a driver. The goal is to visit each campus at least twice a month.
CPAL, Parkland, and Dallas College deserve a lot of credit for their perseverance in this project. Finding the right buses, drafting contracts between the three organizations, going through the legal department, and making sure all the details were in compliance with Parkland’s standards was a difficult and at times mind-boggling task.
Fortunately, the three partners didn’t give up. Unintended pregnancy significantly reduces a woman’s chances of graduating from high school or college. Family planning leads to success for women. They’re more likely to get the job they want and earn more. As a result, their children grow up in healthier environments and have a better chance of living a better life.
The mobile clinic is part of what Dallas College President Justin Ronon calls an effort to break down barriers. “Women’s health is a big issue,” he said, noting that 60 percent of the college’s 135,000 students are women. “Without these resources, they’re not able to focus on what they need to do in the classroom.”
Luz Gonzalez, associate dean for health services and advancement at the University of Dallas and a nurse for 11 years, said she struggled to understand the health care system because she had immigrant parents and no health insurance.
The mobile clinic is one example of how university officials are working to ensure UT Dallas students don’t feel alone, she said. “We’re helping them succeed now and after they graduate.”
The Dallas College clinic doesn’t have a doctor on-site, so all the nurses can do is “hand out a few condoms and get the students referrals,” Gonzalez said. Going forward, all methods of birth control will be available, along with easy-to-follow educational materials.
Parkland owns and operates the new bus, which was purchased with a CPAL donation from the Community Foundation of Texas W.W. Caruth Jr. Fund and charitable funds from donors to the Parkland Health Foundation.
I had the opportunity to meet with the five women who will be providing care at the mobile clinic – four of them Advanced Practice Healthcare Professionals and one Advanced Registered Nurse – who were excited to show me the bus and share their excitement about their new role.
These frontline staff were selected for their passion to go into their communities and provide care and information, particularly to women who have been underserved for so long.
“Women and girls throughout Dallas County are disproportionately affected by a lack of access to quality reproductive health services,” Dr. Michael Horn, president and CEO of the Parkland Health Foundation, told me. “This should be a wake-up call for all of us who care about our communities.”
Horne pointed to the knock-on effects: “When women and girls have agency and access to information and health services, they are ultimately empowered to maximize their earning potential, which has a clear impact on our communities.”
Nicole McKinley, operations manager for Women and Infants Specialty Health at Parkland, has been involved with the project since its early days, and her story from her time as a family planning counselor highlights the importance of the clinic.
The young woman who came to see McKinley was, he recalled, “a very bright young woman” who had given birth before she turned 18. They completed a questionnaire for her. “Do you have children?” “Do you want children?” “How many and when?” “What are you doing now to avoid having children in case the time isn’t right?”
“I wish someone had asked me these questions two years ago, so I would have had a path forward that would have prompted me to do something about this,” the patient said, according to McKinley.
“Providing contraception is one thing,” McKinley says, “but simply asking those questions is just as important, if not more so.”
These are the kinds of questions that mobile clinic caregivers ask.
