Dear President Obama,

I am writing this under concern for healthcare, but in reality, it is much more than that. I am a woman, a mother, a nurse, a researcher, and a feminist, as such I have to raise the issue of reproductive choices.

As a healthcare issue, it is critical that birth control education and options become available to all women. Unplanned pregnancy is a major financial burden on our society, as many occur in women living below poverty, as are the children that result from these pregnancies.

Unplanned pregnancies often happen in teens, which makes this an education issue as well. In your address to Congress, you stated that it was our responsibility, to provide opportunities to young people obtaining an education. Additionally, you stated that to drop out of school was to fail our country. Yet unplanned teen pregnancies often result in failing to complete school. It is our responsibility to provide these teens with ways to increase their chances of gaining higher education, by education about contraception.

On a different issue related to reproductive choices, the AMA and the ACOG are pursuing legislation to require birth to occur in the hospital. This is not evidenced based legislation, as research bears out that mortality in the home setting is equivalent to the hospital setting, and morbidity is improved.

Hospital based birth is costly, and usually results in interventions that are even more costly. Out of hospital birth and prenatal care usually run in the $3-5,000 range, whereas the typical low-intervention in-hospital birth is at least twice that cost. If one factors in increased morbidity, resulting in prolonged stays for mother and/or infant, and rising C-section rates, this is a major healthcare cost issue.

In short, reproductive education and choices have the potential to decrease healthcare costs, increase the educational level of our youth today, and can improve the economic situation and strength of families in America.

Thank you for your time,
Amanda Aaronson, RN, MSN
Doctoral Student
University of California, San Francisco