By Guest Blogger, former VCW intern Ana Cimino Burke
Advancing public policy grounded in equity and justice is a passion of Ana’s. She has taken this passion and using her infertility journey as a backdrop, penned this piece, using the keypad to hold space for folks who want to share their stories and list what support resources exist because affordable, safe, and quality fertility care IS an economic, racial, and reproductive justice issue.
*To honor the confidentiality of interviewees who wished to remain anonymous, I wove their voice into the article or, in two instances, changed their names to Samuel and Jane.
After a year of struggling to conceive, I sought help from a fertility specialist in 2019. I discovered that I have a unicornuate uterus (half of a uterus with one functioning fallopian tube). In short, this rare condition makes it difficult to conceive and carry a baby to term. Warning: the google trap will steer you down a hole littered with frightening statistics. Proceed with caution or avoid it altogether. I had surgery in October 2019 to remove the nonfunctioning fallopian tube and to make sure the other was not blocked. I remember waking up from surgery and through the fog muttered one word, “IVF?” My doctor knew what I meant. I was asking whether my remaining tube was blocked, which, if it was, my only option would be In Vitro Fertilization [IVF]. IVF is cost prohibitive and more invasive than Intrauterine Insemination [IUI]. She told me, “no IVF.” Fast forward through three failed IUIs between January and June 2020 [we skipped, of course, April and May because of COVID-19]. Our doctor encouraged us not to give up on IUI, so we are trying IUI number four this month.
When I try to explain what infertility means to me, the feeling that most often presents itself is shame – shame and I are well acquainted, but that’s another story for another time. I want to dismantle the socially constructed expectations of family and womxn that perpetuate this shame, but I also want to validate that for so many struggling with infertility, shame is the common thread that holds us together. Compounding my shame is the growing financial burden, grief, and my silent suffering – in 2019 I fell into a deep, I mean deep, depression. I found myself wanting to shield others from feeling like they were going to “say the wrong thing” if we mentioned it. I did not want them to feel guilty for how quickly they became pregnant for the first or second time. But also, I did not want to hear their opinion on whether or not I should jump to – without knowing our financial situation - IVF or adoption. So, I only spoke about it with a few people, and similar to the way I cope with other traumatic events in my life, I quickly hid my pain behind a smile and witty quip.
The pandemic has stirred some additional feelings of anxiety and immense guilt – guilt because I am obsessed with conceiving while the world is figuratively and literally on fire. Although I am grateful to access a safety net by phone or web, I am missing the comfort of my partner’s presence during my procedures. At my clinic, partners are not allowed in the room during check-ups or IUI procedures under COVID-19, which I appreciate as it is necessary to maintain public health, but each time I visit the doctor, I am alone. I know there are so many who have experienced this feeling for a variety of reasons.
I now find it cathartic to share my story because fertility treatment robs you of a feeling of calmness and control. But I recognize that, as a white, heterosexual, cis-woman with access to medical care and decent insurance, how disparate the experience is for persons who identify as BIPOC and/or LGBTQ+ or non-binary, especially when discrimination and racism permeate our institutional and social structures. Consequently, I decided to use the pen – er, keypad - to hold space for folks who want to share their stories and list what support resources exist because affordable, safe, & quality fertility care IS a reproductive, economic & racial justice issue. When we care for and invest in every member of our community and their needs, we participate in collective community care and build a world in which everyone thrives.
I began my research by digging into various articles online and then posting on social media to elicit stories from those who wanted to come forward – anonymous or otherwise. I framed the topic around the impact of infertility, socially constructed expectations on family planning, and the barriers to accessing affordable, safe & quality fertility healthcare. I received several messages and a few from folks who wished to answer these questions in addition to a few more that I drafted.
Although most diagnostic care is covered by insurance, treatment is not. And if you do not have insurance or the one you do have is lackluster, the financial barrier to reproductive healthcare is heavy. According to an article written by Jessica Grose in the New York Times, IVF remains an untenable financial barrier to family planning. Specifically, Grose notes, “in the United States the average cost per cycle of I.V.F. is over $10,000, and most infertile couples pay that fully out of pocket, as fertility treatment is not a benefit health insurance tends to cover.” To me, this kind of treatment is designed for the wealthy – who, more often than not, as a result of systemic racism and discrimination – are white, heterosexual, and cisgender.
Samuel*, who identifies as a person of color, heterosexual, and cis-man, shared that after a little over three years of trying to conceive, his family decided to try IVF treatment. Although costly, his partner and he made the choice because they are both sickle cell trait carriers and the general testing associated with IVF also screens for sickle cell. Samuel and his partner went through two rounds of IVF, the second producing a viable embryo that attached. However, it was not without heartache. They originally had 33 eggs, but only had only one viable embryo. Devastated and exhausted, they carried on like so many before them. The last embryo attached and seven days after their fifth wedding anniversary his partner gave birth to a healthy baby. But this all came at a cost. At the time, they did not have comprehensive insurance and he could not use his partner’s insurance for his diagnostic care, so they paid for both out of pocket. In order to do so, they took out a home equity line of credit, used money from a retirement account, paid for some charges using a credit card, and received financial assistance from family. Samuel and his partner are not alone. Thousands of individuals and families are forced into substantial debt to cover the exorbitant costs of fertility care and treatment. Samuel told me that the total cost of all the fertility treatments including both IVF procedures and genetic testing was approximately $42,000 and three years later, they are still paying off some of the debt. But he remarked that even with the heartache and financial setbacks, he would do it again to have his daughter.
Jane* who identifies as a queer, white cis-woman, did not know where to begin and what the first steps would be – should they try at home first or seek fertility treatment right away? They started with IUI, but relied on an anonymous sperm donor. Jane remarked at the surprising expense of a sperm donation – an expense most cis-hetero couples do not have to face - and there are not a lot of accessible sperm banks in New England. They ultimately used one in Boston after learning about a longstanding partnership with the University of Vermont which benefited them a 40% discount on the cost of the donations. But not everyone knows about this partnership so it would be helpful for individuals and families to have as much digestible information about the costs associated with fertility treatment before making these decisions. For many, the automatic expense of sperm donation, IUI procedure, or other fertility care is an untenable barrier to creating a family.
In my research, I came across an article describing a fertility equality movement which is grounded in the idea that creating families should not be determined by financial status, sexuality, gender, or biology. This viewpoint disrupts the heteronormative view of fertility and family planning. Although some states do mandate insurance coverage there is more red tape that often precludes people – especially LGBTQ+ families or individuals – from accessing coverage. This movement is to ensure affordable coverage for everyone and to dismantle the additional legal or social barriers experienced by LGBTQ+ couples and individuals who want to start a family. Mario Leigh, the founder of Affordable Families, a Connecticut based advocacy organization, is partnering with Representative Liz Linhan to draft a bill with inclusive language and more affordable, robust insurance coverage.
Institutional & Social Barriers
According to Women’s Health Magazine, who, in partnership with the Black Women’s Health Imperative, conducted a survey among 1,000 women of multiple races, found that “black women were more than twice as likely as white women to say that they wouldn’t feel comfortable talking about their fertility issues with friends, family, a partner, their doctor, or even a support group.” The article then explains that for many, this stems from “a distrust of the medical system” originating from oppressive care and racial discrimination. We have heard the narrative and seen the statistics, BIPOC women are at a higher risk for maternal mortality than white women because of a lack of access to comprehensive care and education about reproductive health – both of which are inextricably linked to systemic racism. Samuel* found that in addition to the financial impact, there is a lack of awareness and education in his community around reproductive health for people who identify as male. He shared that in his family it is expected to have children and a lot of them. So much so that during each joyful gatherings with family, conversations centered on when he and his partner would have children, but not on reproductive health or fertility risks. He also shared that when they did not conceive right away, the assumption was that his partner, a cis-woman, was to blame – either she did not want kids or was infertile. It wasn’t until he sought fertility treatment that he learned he has oligospermia (low sperm count), varicocele, and testicular microlithiasis (a possible risk factor for testicular cancer). His partner is fertile. He did not like that his wife was taking the blame for something that was not her fault, but that people assumed she was to blame – I would like to emphasize that infertility is no one’s fault. Because of his experience, he wants to demystify the shame that men might feel when seeking sperm analysis or diagnostic care and encourages prioritization of their reproductive health. And to remind them of their role in this journey, too, and that the testing, research, and stress should not fall on one partner – regardless of their fertility – because you’re a team.
Additionally, BIPOC or LGBTQ+ folks generally do not see themselves reflected in mainstream advocacy efforts or educational materials. In response, leaders like Regina Townsend, who started The Broken Brown Egg, are creating organizations and groups to increase representation, education, and discussion. On her website, she remarks, “infertility is lonely enough without feeling like a minority inside of a minority.” In my conversation with Jane* she stressed how mainstream messaging is geared towards cis-hetero individuals and is often paralleled by exclusionary insurance and a medical system that uses language such as “natural conception” or assumes that the more feminine presenting person in a couple will be the gestational carrier. The unintended consequence is an invalidation of a person or couple’s family planning process. She added that this mirrors the messaging she received as a teen. I, as well as several others I spoke with, can relate. In high school and in conservative or religious rhetoric, we are often told we cannot become pregnant. That we must remain abstinent to be a “good” and “pure” girl so we can have families after marriage. This myopic, cis-hetero, and sexist viewpoint perpetuate a false narrative that people cannot own their sexuality and ultimately – reproductive health.
Compounding these experiences are a lack of access to treatment centers or support networks for some. In rural states like Vermont with a limited public transportation system, fertility clinics or support groups might be difficult to physically access. Jessica Grose writes that “40 percent of American women of reproductive age have limited or no access to nearby fertility treatments.” Arguably this is shifting under the pandemic as telehealth has become a mainstay, but for folks without internet access or reliable transportation to appear for IUI or IVF appointments, this remains an institutional barrier to reproductive care and treatment.
So, where do we go from here?
I feel like I have only scratched the surface – I am missing so much here. I want to conduct more interviews and research to gather statistics and harness the power of those experiencing infertility into legislative action and policy change including a thorough analysis of current insurance coverage, what other states are doing, and how that would work in Vermont – for everyone. I want the state to pass comprehensive legislation mandating accessible and comprehensive insurance coverage for fertility treatment and ultimately, dismantle other economic and social barriers to fertility care. Because affordable, safe, & quality fertility care IS a reproductive, economic & racial justice issue.
For now, I hope these short pieces highlight the profound feelings and experiences attached to infertility. Jane* feels lucky to have a strong support network of friends and families who ground their love in compassionate community care. But we discussed how we need more community spaces that normalize fertility treatment where people feel connected and supported; no longer hidden behind the pain and silent suffering.
If you’re experiencing infertility, we see you.
This list is not exhaustive and I am only scratching the surface.
- Guide to fertility insurance by state: https://modernfertility.com/blog/your-guide-to-fertility-insurance-coverage-by-state/
- Grants to cover infertility costs: http://www.cadefoundation.org/
o Resolve *state by state list of Fertility doctors.
o Chapter Organization – Fertility for Colored Girls
The 2019-2020 Session of the Vermont General Assembly adjourned on September 25th, 2020.
By Kellie Campbell, Chair of the Vermont Commission on Women’s Education & Human Development Committee and Hannah Lane, Policy Analyst & Business Manager for the Vermont Commission on Women.
Policy decisions regarding education and child care are gendered. That is a fact that must not be ignored. As public schools in Vermont reopen using a variety of learning models, data signals working women stand to bear the brunt of the impacts. Women experience this from multiple sides: they continue to be primarily responsible for the majority of child-rearing and caregiving, and they make up the vast majority of Vermont’s teachers[i] and child care providers[ii]. Many educators will feel this burden doubly, balancing their careers and the needs of their students with the needs of their own children.
Most of Vermont’s students will learn virtually at least some, if not most, of the time this fall. Many parents must navigate that change while balancing employment, increased family responsibilities, and supporting children’s virtual learning. Women will overwhelmingly be the ones who are forced to pull back from their careers to meet this challenge.
Data from the Census Household Pulse survey, conducted in late April and early May, found that over 80% of U.S. adults who weren’t working because they had to care for their children who were not in school or daycare were women.[iii] Even before the pandemic, mothers were 40% more likely than fathers to report that they had personally felt the negative impact of child care issues on their careers;[iv] 3 times as likely as men to report that at some point they quit a job so that they could care for family;[v] 7 times more likely to cite childcare problems as a reason for working part-time;[vi] and 4 times more likely than men to take time off work when children are sick.[vii] Moreover, women are significantly more likely to be navigating this crisis as single parents; 21% of all children in the United States live only with their mother, compared to 4% living with their father only.[viii]
As policymakers and communities consider how to provide children with care and education during this pandemic, and how to support Vermonters in getting back to work, the need for a strong early childhood care and education infrastructure has become increasingly visible. While Vermont’s child care providers are paid as much as $20,000 less per year than similarly-qualified and deserving individuals teaching in the K-12 system,[ix] they have not been the beneficiaries of the well-deserved and fierce advocacy we’ve seen for public school teachers. Child care providers have been caring for essential workers’ children throughout the pandemic, and most reopened to all children over the summer. Vermont has made additional investments including offering grants to child care businesses, but along with those investments, child care workers are now being asked to carry an even heavier burden by providing care and support to our K-12 students on days they aren’t at school.
A successful plan for the reopening of schools will be one that provides for safe and adequate care and education of Vermont’s children and takes into consideration the needs of educators and working parents. Economic support for families with lost earning potential due to COVID’s impacts must be built in to ensure success. Vermont parents need adequate unemployment benefits, paid family and medical leave, and the ability to take care of their families without losing their income. They need universal health insurance, so when crisis strikes, families and kids don’t lose their health care. They need public benefits like Reach Up, 3SquaresVT, and the Child Care Financial Assistance Program that keep up with inflation and deliver enough aid to meet their families' needs. And they need significant investments in Vermont’s child care system, and in our early childhood educators, to ensure high-quality, affordable early care and learning and after-school opportunities exist so working parents can get back to, and remain, in the workforce.
Women in Vermont need our state to develop and implement a holistic, thoughtful plan designed with pre-existing inequities in mind. It must be designed to work for all of us and ensure that the burden of this pandemic does not continue to rest disproportionately on women. Without this plan, the risk of downward economic spiral not only harms families, but communities and the state’s overall economic recovery and future. Our strong state is resilient, and Vermont will recover from COVID-19, but that only happens successfully if we are looking out for one another. Together, and with fair and equitable policy solutions, we can all recover.
[i] Pache, Tiffany Danitz. “Vermont teachers say they feel ‘attacked’ by policymakers.” VTDigger, 2/7/2018. https://vtdigger.org/2018/02/07/vermont-teachers-survey-fault-policy-mak...
[ii] Change the Story, “2019 Status Report: Women, Work, and Wages in Vermont,” 2019. https://changethestoryvt.org/wpcontent/uploads/2019/12/WomenWorkWages2019.pdf
[iii] Grose, Jessica. “They Go to Mommy First.” New York Times, 7/16/2020. https://www.nytimes.com/2020/07/15/parenting/working-moms-coronavirus.html
[iv] [iv] Halpin, John et al. “Affordable Child Care and Early Learning for All Families.” 2018, Center for American Progress. https://cdn.americanprogress.org/content/uploads/2018/09/12074422/ChildCarePolling-report.pdf
[v] Parker, Kim. “Women more than men adjust their careers for family life.” Pew Research Center, 10/2/15. https://www.pewresearch.org/fact-tank/2015/10/01/women-more-than-men-adjust-their-careers-for-family-life/
[vi] Change the Story, “2019 Status Report: Women, Work, and Wages in Vermont,” 2019. https://changethestoryvt.org/wpcontent/uploads/2019/12/WomenWorkWages201....
[vii] Kaiser Family Foundation. “Women, Work, and Family Health: Key Findings from the 2017 Kaiser Women’s Health Survey.” https://www.kff.org/womens-health-policy/issue-brief/women-work-and-family-health-key-findings-from-the-2017-kaiser-womens-health-survey/3/13/2018.
[ix] Horotwitz, Jen. “Stalled at the Start.” Let’s Grow Kids, January 2020. https://www.letsgrowkids.org/client_media/files/pdf/StalledatStart2020.pdf
As families prepare for going back to school, remember the children and youth who are in foster care. While it's a hectic time for everyone, it can be particularly unsettling for children and youth who are not able to return to their birth or adoptive families. The Department for Children and Families seeks Vermonters to step forward and offer foster, kin, or occasional respite care. Explore the process of becoming a licensed foster parent to a child or youth in need by filling out the Foster Care Inquiry Form. Staff at each of the 12 Family Services Division district offices can field inquiries as well.
Barre's New Clothing Closet
By Guest Blogger, Mary L Collins, DCF, Family Services Division
Walk past this historic building in downtown Barre and you might never know that inside lies a bounty of clothing, supplies and toys for children and youth that has been gathered over the past year by Recruitment & Retention Specialist, Alona Tate, for the Barre District Family Services Division of DCF.
With more than 1100 children and youth in foster care throughout Vermont, the needs for clothing, back to school supplies and comfort items is great.
"I reached out to some of our community partners and was delighted to hear from Barre Rotary who helped us to secure this historic space." Tate explained. "Barre Rotary completely renovated the space, including putting in shelving and floor coverings, as well as obtaining supplies and support from Calvin Wilson at Wilson Woodworks for new shelving." She adds, "Rotary does a tremendous amount of “hands on work” within our community!"
The second floor offices have been transformed into a clothing closet with items for all ages. Tate has cleaned, sorted, organized, displayed and then picks items for foster families who have a child in their care who could benefit from additions to their wardrobe.
"I never know what I might receive and so I spend time sorting and organizing and choosing the best items to make it easier for the families and children." Tate packs up totes for every family that expresses a need - whether they're fostering a newborn or a growing teenager. "It's amazing what is donated!" She said. "One local organization makes beautiful quilts and tote bags by the dozens." Tate holds up a calico printed baby quilt to show the craftsmanship and care that goes into each item.
Why a clothing closet?
"We have very little room in our offices to properly sort and store clothing but the needs are there," Tate explained. "This family closet allows us to create a more congenial space for staff and volunteers to work in and for foster families to access what they need in a private, discreet and fun way."
Walking through the two generous rooms, Tate has everything sorted by age and gender identification. She has separated items like totes and back packs, shoes, boots, and baby carriers, bicycles and accessories. She says it helps her to keep things in order and to be ready when the need arises.
"I pack totes so that the families can just come and pick them up." she said. "They don't have a lot of extra time to shop, so this is a way to provide them and the children with great clothing and other needs in an efficient and quick way."
Why the need?
"Sometimes a child is moved very suddenly and there really isn't time to gather their belongings. This makes it a little less stressful on the child and helps the foster care provider be ready when a child comes to them."
Tate further explains that teens are especially vulnerable. "Just because you're sixteen, doesn't mean you want to wear uncool clothes." All sizes from petite to Men's and Women's XX are needed. "We have a lot more baby clothes than we do items for older preteen and teenagers," she explains.
The Family Closet is open by appointment: contact Alona at (802) 585-9861 or Alona.Tate@vermont.gov.
(Montpelier) – Speaker of the House, Mitzi Johnson has appointed Ashley Messier of Jericho to serve a four-year term on the Vermont Commission on Women (VCW), the state’s non-partisan commission working to advance rights and opportunities for women and girls.
Commenting on the appointment, Speaker Johnson said, "Ashley Messier immediately impressed me with her dedication to giving a voice to women, girls, transgender, non-binary, and gender non-conforming people impacted by systems of oppression. The Vermont Commission on Women is the only entity in Vermont that expressly considers the broader implications of state policy and budget priorities for women. Ashley's background in combating systemic oppression aligns with the work of the Commission. Her perspective is an important addition as we aim to include more perspectives at the table."
Messier is the executive director of the Women’s Justice and Freedom Initiative. The Initiative supports and advocates for women, girls, transgender, non-binary, and gender non-conforming people impacted by systems of oppression and is expressly committed to prison abolition. Messier’s years of community organizing, advocacy and direct experience with the criminal legal system inform her passionate and powerful approach to advocacy and abolition. She was previously incarcerated at the Chittenden Regional Correctional Facility.
Messier also serves as the Vermont Organizer for the National Council for Incarcerated and Formerly Incarcerated Women and Girls. The Council is a network of formerly and currently incarcerated women and girls committed to reimagining communities and creating the shift from a criminal legal system to community-led human justice. Messier served as a consultant and then as lead Organizer for the American Civil Liberties Union of Vermont’s Smart Justice, a campaign fighting in the legislatures, the courts, in the voting booth, and in the streets to end mass incarceration by addressing sentencing, bail and prosecutorial reform, as well as parole, release and re-entry reforms.
Messier is a member of Vermont’s Human Trafficking Task Force and participates on its Housing sub-committee. Her related work includes an active role in an Act 146 work group exploring using restorative justice in domestic and sexual violence and stalking cases..